1760746994 NPI number — HUDSON VALLEY HEMATOLOGY ONCOLOGY ASSOCIATES, RLLP

Table of content: (NPI 1760746994)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760746994 NPI number — HUDSON VALLEY HEMATOLOGY ONCOLOGY ASSOCIATES, RLLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON VALLEY HEMATOLOGY ONCOLOGY ASSOCIATES, RLLP
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:
1760746994
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 BAKER AVENUE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12601-1375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-454-1942
Provider Business Mailing Address Fax Number:
845-452-4638

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 WESTAGE BUSINESS CENTER DRIVE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
FISHKILL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12624-2231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-896-8510
Provider Business Practice Location Address Fax Number:
845-896-8590
Provider Enumeration Date:
07/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KANCHERLA
Authorized Official First Name:
RAMAMOHANA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
845-454-9142

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , 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: W15091 . This is a "PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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