Provider Demographics
NPI:1013134964
Name:HUDSON VALLEY HEALTH GROUP
Entity Type:Organization
Organization Name:HUDSON VALLEY HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-565-9800
Mailing Address - Street 1:3141 US ROUTE 9W
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6709
Mailing Address - Country:US
Mailing Address - Phone:845-565-9800
Mailing Address - Fax:845-565-4801
Practice Address - Street 1:3141 US ROUTE 9W
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6709
Practice Address - Country:US
Practice Address - Phone:845-565-9800
Practice Address - Fax:845-565-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093203-1207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00151271Medicaid
NYC10256Medicare UPIN
NY478831Medicare ID - Type Unspecified