Provider Demographics
NPI:1558414714
Name:ADVANCED ORTHOPEDICS OF THE HUDSON VALLEY,PLLC
Entity Type:Organization
Organization Name:ADVANCED ORTHOPEDICS OF THE HUDSON VALLEY,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUSCHENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:845-565-5309
Mailing Address - Street 1:21 LAUREL AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1469
Mailing Address - Country:US
Mailing Address - Phone:845-534-5768
Mailing Address - Fax:845-534-5917
Practice Address - Street 1:21 LAUREL AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1469
Practice Address - Country:US
Practice Address - Phone:845-534-5768
Practice Address - Fax:845-534-5917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6134440001Medicare NSC