HUDSON HEADWATERS HEALTH NETWORK NPI 1679358873

NPI Information

  • NPI: 1679358873
  • Provider Name: HUDSON HEADWATERS HEALTH NETWORK
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 33D2304509
  • Address: 203 OLD MILITARY RD
    LAKE PLACID, NY
    ZIP 12946
  • Phone: (518) 824-2564

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NPI Details

HUDSON HEADWATERS HEALTH NETWORK is a primary care clinic center in Lake Placid, NY. HUDSON HEADWATERS HEALTH NETWORK NPI is 1679358873. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

203 OLD MILITARY RD
LAKE PLACID, NY
ZIP 12946-738
Phone: (518) 824-2564
Fax: (833) 448-3029

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 33D2304509 - federally qualified health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/28/2023 and was last updated on 2/24/2024.

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
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)No
4363A00000XPhysician AssistantNo
5363LF0000XNurse PractitionerFamilyNo
6261QP2300XClinic/CenterPrimary CareYes

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: 3/30/2025

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