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General NPI Number Information
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NPI Number | 1679577191
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Entity Type | Individual
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Provider Name | ROGER C. HUSTED MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 6734 ROUTE 9
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City | RHINEBECK
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State | NY
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Zip | 12572-3724
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Country | US
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Telephone | 845-231-5600
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Fax | 845-202-6042
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Provider Business Mailing Address
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Address Line | 110 S BEDFORD RD CAREMOUNT MEDICAL PC
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3446
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Country | US
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Telephone | 914-241-1050
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Fax | 914-242-1516
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 2210101
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 221010
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License Number State | NY
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