Provider Demographics
NPI:1477502284
Name:HUDSON VALLEY HOSPITALISTS, PC
Entity Type:Organization
Organization Name:HUDSON VALLEY HOSPITALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-751-1016
Mailing Address - Street 1:30 PROSPECT AVE FL 1
Mailing Address - Street 2:C/O EMERGENCY TREATMENT ASSOCIATES
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2908
Mailing Address - Country:US
Mailing Address - Phone:518-751-1016
Mailing Address - Fax:518-751-1020
Practice Address - Street 1:71 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2907
Practice Address - Country:US
Practice Address - Phone:518-828-7601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02544558Medicaid
NY02544558Medicaid