Provider Demographics
NPI:1194842526
Name:HUDSON VALLEY PHYSICAL MEDICINE &REHABILITATION,PLLC
Entity Type:Organization
Organization Name:HUDSON VALLEY PHYSICAL MEDICINE &REHABILITATION,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANNICHIARICO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:914-592-9600
Mailing Address - Street 1:24 SAW MILL RIVER RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1541
Mailing Address - Country:US
Mailing Address - Phone:914-592-9600
Mailing Address - Fax:914-631-0943
Practice Address - Street 1:24 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1541
Practice Address - Country:US
Practice Address - Phone:914-592-9600
Practice Address - Fax:914-631-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192626208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWS970OtherOXFORD ID NUMBER
NY1089696OtherUNITED HEALTH ID NUMBER
NY72Z981OtherBC-BS ID NUMBER
NYWS970OtherOXFORD ID NUMBER
NY=========OtherMAGNACARE ID NUMBER
NY=========OtherBEECHSTREET ID NUMBER
NY81H171Medicare ID - Type UnspecifiedINDIVIDUAL ID NUMBER
NY=========OtherMAGNACARE ID NUMBER