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General NPI Number Information
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NPI Number | 1114093358
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Entity Type | Organization
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Legal Business Name | HUDSON VALLEY MEDICAL GROUP, P.C.
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 4236 ALBANY POST RD
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City | HYDE PARK
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State | NY
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Zip | 12538-1747
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Country | US
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Telephone | 845-229-2600
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Fax | 845-229-1031
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Provider Business Mailing Address
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Address Line | 4236 ALBANY POST RD
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City | HYDE PARK
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State | NY
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Zip | 12538-1747
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Country | US
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Telephone | 845-229-2600
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Fax | 845-229-1031
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PATRICIA IRENE SHANNON
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Credential |
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Telephone | 845-229-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1544321
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 1662161
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License Number State | NY
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