Basic Information
| Provider Information | |||||||||
| NPI: | 1851413769 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOX | ||||||||
| FirstName: | ROSANNE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 185 GREEN STREET, SUITE 2 | ||||||||
| Address2: | HUDSON VALLEY PSYCHIATRIC ASSOCIATES | ||||||||
| City: | KINGSTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 124014248 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453393736 | ||||||||
| FaxNumber: | 2675973622 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 MARY'S AVENUE | ||||||||
| Address2: | HEALTH ALLIANCE MARY'S AVENUE CAMPUS/BENEDICTINE HOSPIT | ||||||||
| City: | KINGSTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453382500 | ||||||||
| FaxNumber: | 2675973622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2007 | ||||||||
| LastUpdateDate: | 05/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | MD066863L | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | 269635-1 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 101530256 | 05 | PA | MEDICAID | 117012 | 01 | PA | CBH | OTHER |