Provider Demographics
NPI:1477675783
Name:HUDSON VALLEY PHYSICIANS PC
Entity Type:Organization
Organization Name:HUDSON VALLEY PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:PODESZWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-343-4500
Mailing Address - Street 1:419 E MAIN ST
Mailing Address - Street 2:STE. 101
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2552
Mailing Address - Country:US
Mailing Address - Phone:845-343-4500
Mailing Address - Fax:845-343-0251
Practice Address - Street 1:419 E MAIN ST
Practice Address - Street 2:STE. 101
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2552
Practice Address - Country:US
Practice Address - Phone:845-343-4500
Practice Address - Fax:845-343-0251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171862174400000X
NY215361174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02148369Medicaid
NY01970621Medicaid
NY02148369Medicaid
NY01970621Medicaid
NYE48858Medicare UPIN
NY53F841Medicare ID - Type UnspecifiedJOHN R PODESZWA