Provider Demographics
NPI:1083668735
Name:HUDSON VALLEY ENDOCRINOLOGY, P.C.
Entity Type:Organization
Organization Name:HUDSON VALLEY ENDOCRINOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-691-4600
Mailing Address - Street 1:PO BOX 1557
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-8557
Mailing Address - Country:US
Mailing Address - Phone:845-691-4600
Mailing Address - Fax:845-691-5546
Practice Address - Street 1:29 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-1401
Practice Address - Country:US
Practice Address - Phone:845-691-4600
Practice Address - Fax:845-691-5546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212041174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG81219Medicare UPIN
NY803521Medicare ID - Type Unspecified