Provider Demographics
NPI:1275737934
Name:PODIATRY HME SVCS HUDSON VALLEY
Entity Type:Organization
Organization Name:PODIATRY HME SVCS HUDSON VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-943-6800
Mailing Address - Street 1:35 5 MILE WOODS RD
Mailing Address - Street 2:
Mailing Address - City:CATSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12414-5913
Mailing Address - Country:US
Mailing Address - Phone:518-943-6800
Mailing Address - Fax:518-943-6866
Practice Address - Street 1:35 5 MILE WOODS RD
Practice Address - Street 2:
Practice Address - City:CATSKILL
Practice Address - State:NY
Practice Address - Zip Code:12414-5913
Practice Address - Country:US
Practice Address - Phone:518-943-6800
Practice Address - Fax:518-943-6866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-14
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0359830001Medicare NSC