Provider Demographics
NPI: | 1942540646 |
---|---|
Name: | HEALTH QUEST MEDICAL PRACTICE |
Entity Type: | Organization |
Organization Name: | HEALTH QUEST MEDICAL PRACTICE |
Other - Org Name: | LAGRANGEVILLE PC |
Other - Org Type: | Other Name |
Authorized Official - Title/Position: | PRESIDENT/CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ARUN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | AGARWAL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 845-475-9661 |
Mailing Address - Street 1: | 1351 ROUTE 55 SUITE 200 |
Mailing Address - Street 2: | |
Mailing Address - City: | LAGRANGEVILLE |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 12540-5108 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 845-475-9603 |
Mailing Address - Fax: | 845-475-9938 |
Practice Address - Street 1: | 1100 ROUTE 55 STE 101 |
Practice Address - Street 2: | |
Practice Address - City: | LAGRANGEVILLE |
Practice Address - State: | NY |
Practice Address - Zip Code: | 12540-5050 |
Practice Address - Country: | US |
Practice Address - Phone: | 845-473-0974 |
Practice Address - Fax: | 845-473-5380 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-02-18 |
Last Update Date: | 2013-02-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty |