Basic Information
| Provider Information | |||||||||
| NPI: | 1245593383 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUDSON VALLEY HEMATOLOGY ONCOLOGY ASSOCIATES, RLLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 BAKER AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 126011359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454541942 | ||||||||
| FaxNumber: | 8454524638 | ||||||||
| Practice Location | |||||||||
| Address1: | 6511 SPRING BROOK AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | RHINEBECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125723709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454541942 | ||||||||
| FaxNumber: | 8454524638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2012 | ||||||||
| LastUpdateDate: | 06/22/2012 | ||||||||
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| AuthorizedOfficialLastName: | KANCHERLA | ||||||||
| AuthorizedOfficialFirstName: | RAMAMAOHANA | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 8454541942 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | NY | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
ID Information
| ID | Type | State | Issuer | Description | W15091 | 01 | NY | PTAN | OTHER |