1629443379 NPI number — HUDSON VALLEY ORAL SURGERY, PLLC

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 1629443379 NPI number — HUDSON VALLEY ORAL SURGERY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON VALLEY ORAL SURGERY, PLLC
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:
6
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:
1629443379
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2649 STRANG BLVD., SUITE 202
Provider Second Line Business Mailing Address:
HUDSON VALLEY ORAL SURGERY, PLLC
Provider Business Mailing Address City Name:
YORKTOWN HTS.
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-245-6642
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2649 STRANG BLVD STE 202
Provider Second Line Business Practice Location Address:
HUDSON VALLEY ORAL SURGERY, PLLC
Provider Business Practice Location Address City Name:
YORKTOWN HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10598-2938
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-245-6642
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
PAYAMI
Authorized Official First Name:
ALI
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
914-245-6642

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X , with the licence number:  055476 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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