Provider Demographics
NPI:1598168296
Name:ADVANCED PODIATRY ASSOCIATES OF THE HUDSON VALLEY LLP
Entity Type:Organization
Organization Name:ADVANCED PODIATRY ASSOCIATES OF THE HUDSON VALLEY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:CICCONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-561-7646
Mailing Address - Street 1:1007 ROUTE 82
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6165
Mailing Address - Country:US
Mailing Address - Phone:845-227-6947
Mailing Address - Fax:845-227-6729
Practice Address - Street 1:637 NEW LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-4067
Practice Address - Country:US
Practice Address - Phone:877-216-0240
Practice Address - Fax:845-561-3218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies