Healthcare Provider Details

I. General information

NPI: 1386020766
Provider Name (Legal Business Name): HEALTH QUEST MEDICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2015
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 READE PL SUITE 2100
POUGHKEEPSIE NY
12601-3912
US

IV. Provider business mailing address

1351 ROUTE 55 SUITE 200
LAGRANGEVILLE NY
12540-5108
US

V. Phone/Fax

Practice location:
  • Phone: 845-214-1840
  • Fax: 845-214-1845
Mailing address:
  • Phone: 845-475-9661
  • Fax: 845-475-9938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY KRUGER
Title or Position: VP FINANCE
Credential:
Phone: 845-475-9635