HUDSON HEADWATERS HEALTH NETWORK NPI 1154589083

NPI Information

NPI: 1154589083
Provider Name: HUDSON HEADWATERS HEALTH NETWORK
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 33D2192456

Address:
90 SOUTH ST
GLENS FALLS, NY
ZIP 12801
Phone: (518) 792-7841
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HUDSON HEADWATERS HEALTH NETWORK is a federally qualified health center (fqhc) clinic center in Glens Falls, NY. HUDSON HEADWATERS HEALTH NETWORK NPI is 1154589083. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

90 SOUTH ST
GLENS FALLS, NY
ZIP 12801-328
Phone: (518) 792-7841
Fax: (518) 932-0289

The provider's authorized official is Laura Pasco .
The authorized official title is Executive Vp, Cfo and has the following contact phone number (518) 761-0300.

The CLIA number assigned to this NPI record is 33D2192456 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/28/2008 and was last updated on 2/23/2024.

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
1	207V00000X	Obstetrics & Gynecology				No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03013009	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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