SUN RIVER HEALTH INC NPI 1407910557

NPI Information

NPI: 1407910557
Provider Name: SUN RIVER HEALTH INC
Classification: Clinic/Center - 261QF0400X
Specialization: Federally Qualified Health Center (FQHC)
Entity Type: Organization
CLIA Number: 33D2063273
Address: 23 LAKEWOOD AVE
HUDSON RIVER HEALTHCARE, INC.
MONTICELLO, NY
ZIP 12701
Phone: (845) 794-2010

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NPI Details

SUN RIVER HEALTH INC is a federally qualified health center (fqhc) clinic center in Monticello, NY. SUN RIVER HEALTH INC NPI is 1407910557. The provider is registered as an organization entity type.

The provider's business location address is:

23 LAKEWOOD AVE
HUDSON RIVER HEALTHCARE, INC.
MONTICELLO, NY
ZIP 12701-021
Phone: (845) 794-2010
Fax: (845) 794-4569

The provider's authorized official is Adam Lipton .
The authorized official title is Vp Info/practice Management Systems and has the following contact phone number (914) 384-2375.

The CLIA number assigned to this NPI record is 33D2063273 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2006 and was last updated on 3/13/2022.

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	251B00000X	Case Management				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	00473038	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: 11/21/2025

NPI Synchronization or Removal

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