MEDICARE: HUDSON VALLEY PHYSICIANS PC

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	174400000X	Specialist	171862	NY
2	174400000X	Specialist	215361	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477675783
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON VALLEY PHYSICIANS PC

Provider Business Mailing Address
First Line	:	419 E MAIN ST
Second Line	:	STE. 101
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-2552
Country	:	US
Telephone Number	:	845-343-4500
Fax Number	:	845-343-0251

Provider Business Practice Location Address
First Line	:	419 E MAIN ST
Second Line	:	STE. 101
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-2552
Country	:	US
Telephone Number	:	845-343-4500
Fax Number	:	845-343-0251

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN ROBERT PODESZWA
Credential	:	MD
Telephone Number	:	845-343-4500

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	08/22/2020

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