HUDSON HEADWATERS HEALTH NETWORK NPI 1952319386

NPI Information

NPI: 1952319386
Provider Name: HUDSON HEADWATERS HEALTH NETWORK
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
101 ADIRONDACK DR STE 2
TICONDEROGA, NY
ZIP 12883
Phone: (518) 585-6708
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HUDSON HEADWATERS HEALTH NETWORK is a primary care clinic center in Ticonderoga, NY. HUDSON HEADWATERS HEALTH NETWORK NPI is 1952319386. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

101 ADIRONDACK DR STE 2
TICONDEROGA, NY
ZIP 12883-334
Phone: (518) 585-6708
Fax: (518) 585-3260

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 8/3/2006 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	License State	Primary
1	104100000X	Social Worker		NEW YORK	No
2	133N00000X	Nutritionist		NEW YORK	No
3	207Q00000X	Family Medicine		NEW YORK	No
4	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		No
5	208000000X	Pediatrics		NEW YORK	No
6	213E00000X	Podiatrist		NEW YORK	No
7	363L00000X	Nurse Practitioner		NEW YORK	No
8	367A00000X	Advanced Practice Midwife		NEW YORK	No
9	363A00000X	Physician Assistant		NEW YORK	No
10	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	03289883	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: 4/28/2024

NPI Synchronization or Removal

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