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NPI Code Detail

MEDICARE: HUDSON VALLEY HOSPITAL PHYSICIAN PLLC

MEDICARE: HUDSON VALLEY HOSPITAL PHYSICIAN PLLC
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
1207R00000XInternal Medicine Physician

Other Identifiers

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

General Provider Information

NPI Number : 1548216831
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUDSON VALLEY HOSPITAL PHYSICIAN PLLC
Provider Business Mailing Address
First Line : PO BOX 1013
Second Line :
City : GOSHEN
State : NY
Zip : 10924-8013
Country : US
Telephone Number : 845-615-1141
Fax Number : 845-294-4333
Provider Business Practice Location Address
First Line : 60 PROSPECT AVE
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10940-4133
Country : US
Telephone Number : 845-342-7615
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DIANE SPAGNOLI PINE
Credential : MD
Telephone Number : 845-342-7615
Provider Enumeration Date : 05/26/2006
Last Update Date : 08/22/2020

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