Healthcare Provider Details

I. General information

NPI: 1790062313
Provider Name (Legal Business Name): ADVANCED PODIATRY ASSOCIATES OF THE HUDSON VALLEY LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 11/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WEBSTER AVE STE 301 THE ATRIUM AT ST. FRANCIS
POUGHKEEPSIE NY
12601-1364
US

IV. Provider business mailing address

1 WEBSTER AVE STE 301 THE ATRIUM AT ST. FRANCIS
POUGHKEEPSIE NY
12601-1364
US

V. Phone/Fax

Practice location:
  • Phone: 845-483-5809
  • Fax:
Mailing address:
  • Phone: 845-483-5809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNY

VIII. Authorized Official

Name: PATRICK GRIPPO
Title or Position: OWNER
Credential: DPM
Phone: 845-483-5809