Basic Information
| Provider Information | |||||||||
| NPI: | 1477051589 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUDSON VALLEY REGIONAL COMMUNITY HEALTH CENTERS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 MOUNT EBO RD S | ||||||||
| Address2: | |||||||||
| City: | BREWSTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105094004 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 15 MOUNT EBO RD S | ||||||||
| Address2: | |||||||||
| City: | BREWSTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105094004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8458789078 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2018 | ||||||||
| LastUpdateDate: | 02/14/2018 | ||||||||
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| AuthorizedOfficialLastName: | YAGER | ||||||||
| AuthorizedOfficialFirstName: | HOWARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHAIRMAN OF THE BOARD | ||||||||
| AuthorizedOfficialTelephone: | 8458789078 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | 3922200R | NY | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.