Provider Demographics
NPI:1629443379
Name:HUDSON VALLEY ORAL SURGERY, PLLC
Entity Type:Organization
Organization Name:HUDSON VALLEY ORAL SURGERY, PLLC
Other - Org Name:HUDSON VALLEY ORAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MD
Authorized Official - Phone:914-245-6642
Mailing Address - Street 1:2649 STRANG BLVD., SUITE 202
Mailing Address - Street 2:HUDSON VALLEY ORAL SURGERY, PLLC
Mailing Address - City:YORKTOWN HTS.
Mailing Address - State:NY
Mailing Address - Zip Code:10598
Mailing Address - Country:US
Mailing Address - Phone:914-245-6642
Mailing Address - Fax:
Practice Address - Street 1:2649 STRANG BLVD STE 202
Practice Address - Street 2:HUDSON VALLEY ORAL SURGERY, PLLC
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2938
Practice Address - Country:US
Practice Address - Phone:914-245-6642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0554761223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty