Provider Demographics
NPI:1710990999
Name:EUGENE P HESLIN MD PC
Entity Type:Organization
Organization Name:EUGENE P HESLIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:P
Authorized Official - Last Name:HESLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-246-3000
Mailing Address - Street 1:16 W BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-1415
Mailing Address - Country:US
Mailing Address - Phone:845-246-3000
Mailing Address - Fax:845-246-7622
Practice Address - Street 1:16 W BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-1415
Practice Address - Country:US
Practice Address - Phone:845-246-3000
Practice Address - Fax:845-246-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1900231207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYEU0W4L3010OtherEMPIRE BLUE CROSS
NY5435OtherCDPHP
NY102769OtherAETNA
NYCN3248OtherRAILROAD MEDICARE
NY5435OtherCDPHP