Provider Demographics
NPI:1578752085
Name:NEW WINDSOR GYNECOLOGY, PC
Entity Type:Organization
Organization Name:NEW WINDSOR GYNECOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZESZUTEK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:845-567-3420
Mailing Address - Street 1:575 HUDSON VALLEY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-4747
Mailing Address - Country:US
Mailing Address - Phone:845-567-3420
Mailing Address - Fax:845-567-3421
Practice Address - Street 1:575 HUDSON VALLEY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-4747
Practice Address - Country:US
Practice Address - Phone:845-567-3420
Practice Address - Fax:845-567-3421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-20
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233468207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02600737Medicaid
NYWRRTW1Medicare PIN