TABASCO FAMILY PRACTICE PLLC NPI 1073701579

NPI Information

  • NPI: 1073701579
  • Provider Name: TABASCO FAMILY PRACTICE PLLC
  • Classification: Family Medicine - 207QA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • Doing Business As: TABASCO HEALTH CARE
  • CLIA Number: 33D2045260
  • Address: 5 GOLDEN LN
    KERHONKSON, NY
    ZIP 12446
  • Phone: (845) 626-3424

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NPI Details

TABASCO FAMILY PRACTICE PLLC is an addiction medicine family medicine in Kerhonkson, NY. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. TABASCO FAMILY PRACTICE PLLC NPI is 1073701579. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Tabasco Health Care.

The provider's business location address is:

5 GOLDEN LN
KERHONKSON, NY
ZIP 12446-609
Phone: (845) 626-3424
Fax: (845) 626-4627

The provider's authorized official is Lucinda Grovenburg .
The authorized official title is President and has the following contact phone number (845) 626-3424.

The CLIA number assigned to this NPI record is 33D2045260 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/9/2007 and was last updated on 10/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QA0401XFamily MedicineAddiction Medicine188450NEW YORKYes

What is NPI?

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This page was last updated on: 11/21/2025

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