Provider Demographics
NPI:1346437696
Name:HUDSON VALLEY UROLOGY ASSOCIATES P.C.
Entity Type:Organization
Organization Name:HUDSON VALLEY UROLOGY ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJIT
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:ANTONY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-562-2404
Mailing Address - Street 1:3074 ROUTE 9W STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6751
Mailing Address - Country:US
Mailing Address - Phone:845-562-5520
Mailing Address - Fax:845-562-5556
Practice Address - Street 1:3074 ROUTE 9W STE 100
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6751
Practice Address - Country:US
Practice Address - Phone:845-562-5520
Practice Address - Fax:845-562-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124967208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY324251Medicare PIN