Provider Demographics
NPI:1093746505
Name:HUDSON VALLEY EMERGENCY MEDICINE PLLC
Entity Type:Organization
Organization Name:HUDSON VALLEY EMERGENCY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:N
Authorized Official - Last Name:VANROEKENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-431-5624
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:HUDSON VALLEY EMERGENCY MEDICINE PLLC
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12602
Mailing Address - Country:US
Mailing Address - Phone:610-668-6471
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:45 READE PLACE
Practice Address - Street 2:VASSAR BROTHERS MEDICAL CENTER
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-431-5624
Practice Address - Fax:610-617-6280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ32681Medicaid
NYQ32681Medicaid