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General NPI Number Information
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NPI Number | 1659666840
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Entity Type | Organization
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Legal Business Name | HUDSON VISTA MEDICAL,PC
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 19 LAUREL AVE # LL1
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City | CORNWALL
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State | NY
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Zip | 12518-1403
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Country | US
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Telephone | 845-534-7080
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Fax | 845-458-4435
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Provider Business Mailing Address
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Address Line | 70 DUBOIS STREET 5TH FLOOR ADMINISTRATION
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City | NEWBURGH
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State | NY
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Zip | 12550
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Country | US
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Telephone | 845-458-4855
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Fax | 845-458-4853
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. THOMAS GIBNEY
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Credential |
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Telephone | 845-568-2881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NY
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