Basic Information
| Provider Information | |||||||||
| NPI: | 1477893022 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTH QUEST MEDICAL PRACTICE | ||||||||
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| OtherOrganizationName: | RHINEBECK PC | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1351 ROUTE 55 SUITE 200 | ||||||||
| Address2: | |||||||||
| City: | LAGRANGEVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125405108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454759603 | ||||||||
| FaxNumber: | 8454759938 | ||||||||
| Practice Location | |||||||||
| Address1: | 6511 SPRING BROOK AVE | ||||||||
| Address2: | SUITE 1001 | ||||||||
| City: | RHINEBECK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125723709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8458764432 | ||||||||
| FaxNumber: | 8458764439 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2013 | ||||||||
| LastUpdateDate: | 04/14/2016 | ||||||||
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| AuthorizedOfficialLastName: | DOYLE | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 8454759661 | ||||||||
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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 | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.