Provider Demographics
NPI:1548234644
Name:HUDSON VALLEY CARDIOVASCULAR ASSOCIATES PC
Entity Type:Organization
Organization Name:HUDSON VALLEY CARDIOVASCULAR ASSOCIATES PC
Other - Org Name:HUDSON VALLEY HEART CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING DEPARTMENT MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOURHILL
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CEMC, PMCC
Authorized Official - Phone:845-473-1188
Mailing Address - Street 1:1 COLUMBIA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3923
Mailing Address - Country:US
Mailing Address - Phone:845-473-1188
Mailing Address - Fax:845-473-0896
Practice Address - Street 1:1 COLUMBIA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3923
Practice Address - Country:US
Practice Address - Phone:845-473-1188
Practice Address - Fax:845-473-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00524121Medicaid
NYCB5184OtherRAILROAD MEDICARE
NY00524121Medicaid