Provider Demographics
NPI:1598320038
Name:MID-HUDSON FAMILY OPHTHALMOLOGY, PLLC
Entity Type:Organization
Organization Name:MID-HUDSON FAMILY OPHTHALMOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-673-1213
Mailing Address - Street 1:75 CRYSTAL RUN RD STE 104A
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-7003
Mailing Address - Country:US
Mailing Address - Phone:845-673-1213
Mailing Address - Fax:845-673-1045
Practice Address - Street 1:75 CRYSTAL RUN RD STE 104A
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-7003
Practice Address - Country:US
Practice Address - Phone:845-673-1213
Practice Address - Fax:845-673-1045
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID-HUDSON FAMILY OPHTHALMOLOGY, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01741006Medicaid