Provider Demographics
NPI:1770656431
Name:MID-HUDSON ORTHOPEDIC SYSTEMS
Entity Type:Organization
Organization Name:MID-HUDSON ORTHOPEDIC SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:ZWISSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-471-7777
Mailing Address - Street 1:12 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2354
Mailing Address - Country:US
Mailing Address - Phone:845-471-7777
Mailing Address - Fax:845-471-0088
Practice Address - Street 1:12 RAYMOND AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2354
Practice Address - Country:US
Practice Address - Phone:845-471-7777
Practice Address - Fax:845-471-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00584327Medicaid
NY00584327Medicaid