Provider Demographics
NPI:1619163292
Name:MID-HUDSON CHIROPRACTIC HEALTH SERVICES PC
Entity Type:Organization
Organization Name:MID-HUDSON CHIROPRACTIC HEALTH SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:OLMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-221-3555
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-0086
Mailing Address - Country:US
Mailing Address - Phone:845-221-3555
Mailing Address - Fax:845-226-3307
Practice Address - Street 1:1033 ROUTE 82
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6166
Practice Address - Country:US
Practice Address - Phone:845-221-3555
Practice Address - Fax:845-226-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX009583111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYXBWBU1Medicare PIN
NYU81607Medicare UPIN