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General NPI Number Information
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NPI Number | 1942334719
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Entity Type | Organization
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Legal Business Name | MID VALLEY COMPREHENSIVE OBGYN, PC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 28 N FRONT ST
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City | NEW PALTZ
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State | NY
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Zip | 12561-1410
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Country | US
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Telephone | 877-844-3311
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Fax | 845-247-0822
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Provider Business Mailing Address
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Address Line | PO BOX 8084
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City | KINGSTON
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State | NY
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Zip | 12402-8084
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Country | US
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Telephone | 877-844-3311
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Fax | 845-247-0822
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ELAINE P CROSBY
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Credential | MD
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Telephone | 877-844-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 196507
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License Number State | NY
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