1164793725 NPI number — HUDSON VALLEY CENTER FOR DIGESTIVE HEALTH, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164793725 NPI number — HUDSON VALLEY CENTER FOR DIGESTIVE HEALTH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON VALLEY CENTER FOR DIGESTIVE HEALTH, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164793725
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1456 FERRY RD
Provider Second Line Business Mailing Address:
STE 305
Provider Business Mailing Address City Name:
DOYLESTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-589-9024
Provider Business Mailing Address Fax Number:
215-589-9030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1978 CROMPOND RD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
CORTLANDT MANOR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10567-4111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-645-9030
Provider Business Practice Location Address Fax Number:
917-688-3019
Provider Enumeration Date:
01/13/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SABLYAK
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
215-589-9001

Provider Taxonomy Codes

  • Taxonomy code: 261QE0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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