Provider Demographics
NPI:1851417083
Name:MID-HUDSON GASTROENTEROLOGY ASSOCIATES, LLP
Entity Type:Organization
Organization Name:MID-HUDSON GASTROENTEROLOGY ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-739-2400
Mailing Address - Street 1:1985 CROMPOND RD
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4146
Mailing Address - Country:US
Mailing Address - Phone:914-729-2400
Mailing Address - Fax:914-739-2691
Practice Address - Street 1:1985 CROMPOND RD
Practice Address - Street 2:
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4146
Practice Address - Country:US
Practice Address - Phone:914-729-2400
Practice Address - Fax:914-739-2691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW0D271Medicare ID - Type Unspecified