Provider Demographics
NPI:1669192712
Name:NEW WINDSOR FAMILY CARE LLC
Entity type:Organization
Organization Name:NEW WINDSOR FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MINOO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDEOM-SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-562-2191
Mailing Address - Street 1:377 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5301
Mailing Address - Country:US
Mailing Address - Phone:845-562-2191
Mailing Address - Fax:
Practice Address - Street 1:377 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5301
Practice Address - Country:US
Practice Address - Phone:845-562-2191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty