MEDICARE: HILLSIDE HEALTH CARE R.N., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	443900-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225190150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILLSIDE HEALTH CARE R.N., P.C.

Provider Business Mailing Address
First Line	:	260 OSBORNE HILL RD
Second Line	:
City	:	FISHKILL
State	:	NY
Zip	:	12524-2519
Country	:	US
Telephone Number	:	845-440-3940
Fax Number	:

Provider Business Practice Location Address
First Line	:	260 OSBORNE HILL RD
Second Line	:
City	:	FISHKILL
State	:	NY
Zip	:	12524-2519
Country	:	US
Telephone Number	:	845-440-3940
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. BRENDA JOYCE ARDREY
Credential	:	R.N.
Telephone Number	:	845-440-3940

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	08/19/2008

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Directions to “HILLSIDE HEALTH CARE R.N., P.C. ” Practice Location

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