Provider Demographics
NPI:1033235726
Name:HUDSON VALLEY PSYCHOLOGY ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:HUDSON VALLEY PSYCHOLOGY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SCHWALBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-339-2352
Mailing Address - Street 1:159 GREEN ST.
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3737
Mailing Address - Country:US
Mailing Address - Phone:845-339-2352
Mailing Address - Fax:845-339-2382
Practice Address - Street 1:159 GREEN ST.
Practice Address - Street 2:SUITE 1
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3737
Practice Address - Country:US
Practice Address - Phone:845-339-2352
Practice Address - Fax:845-339-2382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY212105000OtherMAGELLAN BEHAVIORAL HLTH.
NY01762110Medicaid