=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477675783
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HUDSON VALLEY PHYSICIANS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 419 E MAIN ST STE. 101
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10940-2552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-343-4500
-----------------------------------------------------
Fax | 845-343-0251
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 419 E MAIN ST STE. 101
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10940-2552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 845-343-4500
-----------------------------------------------------
Fax | 845-343-0251
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JOHN ROBERT PODESZWA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 845-343-4500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 171862
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 215361
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------