Provider Demographics
NPI:1497840060
Name:DUTCHESS SURGICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:DUTCHESS SURGICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYESH
Authorized Official - Middle Name:R
Authorized Official - Last Name:MODI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-473-2727
Mailing Address - Street 1:1 COLUMBIA STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-473-2727
Mailing Address - Fax:845-473-0026
Practice Address - Street 1:1 COLUMBIA STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601
Practice Address - Country:US
Practice Address - Phone:845-473-2727
Practice Address - Fax:845-473-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1699756247OtherNPI
NY1679554224OtherNPI
NY1245211689OtherNPI
NY1467433003OtherNPI