1700066461 NPI number — RAYIM OF HUDSON VALLEY INC.

Table of content: (NPI 1700066461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700066461 NPI number — RAYIM OF HUDSON VALLEY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAYIM OF HUDSON VALLEY INC.
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:
1700066461
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 640
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRIMAN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10926-0640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-782-7700
Provider Business Mailing Address Fax Number:
845-782-7800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 ELM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10950-2805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-782-7700
Provider Business Practice Location Address Fax Number:
845-782-7800
Provider Enumeration Date:
11/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KRAUS
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
845-782-7700

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  43450 , 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)

  • Identifier: 02379808 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02513211 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02701260 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02377282 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02528178 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02583599 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02625432 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02751628 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02596358 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02864744 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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