HUDSON HEADWATERS HEALTH NETWORK NPI 1356355952

NPI Information

NPI: 1356355952
Provider Name: HUDSON HEADWATERS HEALTH NETWORK
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1299 ROUTE 9
GANSEVOORT, NY
ZIP 12831
Phone: (518) 761-6961
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HUDSON HEADWATERS HEALTH NETWORK is a primary care clinic center in Gansevoort, NY. HUDSON HEADWATERS HEALTH NETWORK NPI is 1356355952. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1299 ROUTE 9
GANSEVOORT, NY
ZIP 12831-560
Phone: (518) 761-6961
Fax: (518) 761-1006

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 enumeration date for this NPI number is 7/28/2006 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	Primary
1	213E00000X	Podiatrist		No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	No
3	207R00000X	Internal Medicine		No
4	207RN0300X	Internal Medicine	Nephrology	No
5	363A00000X	Physician Assistant		No
6	208000000X	Pediatrics		No
7	363L00000X	Nurse Practitioner		No
8	207Q00000X	Family Medicine		No
9	261QP2300X	Clinic/Center	Primary Care	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	03289470	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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