Provider Demographics
NPI:1629357769
Name:ADVANCED KIDNEY CARE OF HUDSON VALLEY, PC
Entity Type:Organization
Organization Name:ADVANCED KIDNEY CARE OF HUDSON VALLEY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHUPAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-561-6191
Mailing Address - Street 1:169 N PLANK RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-1723
Mailing Address - Country:US
Mailing Address - Phone:845-561-6191
Mailing Address - Fax:845-561-4145
Practice Address - Street 1:9 LIVINGSTON ST
Practice Address - Street 2:SUITE 1N
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4719
Practice Address - Country:US
Practice Address - Phone:845-471-1335
Practice Address - Fax:845-397-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty