MEDICARE: DORINDA MIDWOOD D.O.

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	207Q00000X	Family Medicine Physician	050130	CT
2	207Q00000X	Family Medicine Physician	272728	NY

General Provider Information

NPI Number	:	1558699405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORINDA MIDWOOD D.O.

Provider Business Mailing Address
First Line	:	1037 MAIN ST
Second Line	:	HUDSON RIVER HEALTHCARE, INC.
City	:	PEEKSKILL
State	:	NY
Zip	:	10566-2913
Country	:	US
Telephone Number	:	914-734-8800
Fax Number	:	914-734-8786

Provider Business Practice Location Address
First Line	:	3174 ROUTE 22
Second Line	:	HUDSON RIVER HEALTHCARE, INC.
City	:	DOVER PLAINS
State	:	NY
Zip	:	12522-5924
Country	:	US
Telephone Number	:	845-877-4793
Fax Number	:	845-877-3139

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	01/08/2014

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