Healthcare Provider Details

I. General information

NPI: 1104825793
Provider Name (Legal Business Name): HUDSON VALLEY ONCOLOGY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 COOKE ST
POUGHKEEPSIE NY
12601-1303
US

IV. Provider business mailing address

712 MAIN ST
MOOSIC PA
18507-1094
US

V. Phone/Fax

Practice location:
  • Phone: 845-485-7767
  • Fax: 845-473-0841
Mailing address:
  • Phone: 570-451-3910
  • Fax: 570-451-3236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE D KOUTCHER
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 845-485-7767