Provider Demographics
NPI:1215410105
Name:HUDSON RIVER HEALTHCARE, INC.
Entity Type:Organization
Organization Name:HUDSON RIVER HEALTHCARE, INC.
Other - Org Name:BRIGHTPOINT BROOKLYN HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VP OF INFORMATION AND PRACTICE MGMT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:LIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-734-7007
Mailing Address - Street 1:PO BOX 5036
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10602-5036
Mailing Address - Country:US
Mailing Address - Phone:855-681-8700
Mailing Address - Fax:718-299-1420
Practice Address - Street 1:803 STERLING PLACE
Practice Address - Street 2:BRIGHTPOINT BROOKLYN HEALTH CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3903
Practice Address - Country:US
Practice Address - Phone:855-681-8700
Practice Address - Fax:718-299-1420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUDSON RIVER HEALTHCARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5901200R261QG0250X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473038Medicaid