Healthcare Provider Details

I. General information

NPI: 1336699313
Provider Name (Legal Business Name): PREMIER MEDICAL GROUP OF THE HUDSON VALLEY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2016
Last Update Date: 10/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 NORTH RD STE 101
POUGHKEEPSIE NY
12601-1173
US

IV. Provider business mailing address

243 NORTH RD STE 304
POUGHKEEPSIE NY
12601-1173
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-9410
  • Fax:
Mailing address:
  • Phone: 845-472-9410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PENNY NAPOLITANO
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 845-471-9410