Healthcare Provider Details

I. General information

NPI: 1487657045
Provider Name (Legal Business Name): EUGENE P HESLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 04/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 WEST BRIDGE ST
SAUGERTIES NY
12477
US

IV. Provider business mailing address

16 WEST BRIDGE ST
SAUGERTIES NY
12477
US

V. Phone/Fax

Practice location:
  • Phone: 845-246-3000
  • Fax: 845-246-7622
Mailing address:
  • Phone: 845-246-3000
  • Fax: 845-246-7622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number190023-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: