1710017876 NPI number — HUDSON VALLEY HOME CARE

Table of content: (NPI 1710017876)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710017876 NPI number — HUDSON VALLEY HOME CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON VALLEY HOME CARE
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:
1710017876
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 PINE STREET SPUR
Provider Second Line Business Mailing Address:
LOWER LEVEL
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12601-3943
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-471-4243
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 PINE STREET SPUR
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12601-3943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-471-4243
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/07/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COOGAN
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
845-471-4243

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  9004L001 , 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: 03006246 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00846951 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00944761 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".