Provider Demographics
NPI:1144372566
Name:WOMENS MEDICAL CARE OF HUDSON VALLEY PC
Entity type:Organization
Organization Name:WOMENS MEDICAL CARE OF HUDSON VALLEY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREI
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:MUNZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-561-0990
Mailing Address - Street 1:9 HUDSON VALLEY PROFESSIONAL PLAZA
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-561-0990
Mailing Address - Fax:845-562-1439
Practice Address - Street 1:9 HUDSON VALLEY PROFESSIONAL PLAZA
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3150
Practice Address - Country:US
Practice Address - Phone:845-561-0990
Practice Address - Fax:845-562-1439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00494317Medicaid
NY00783028Medicaid
NY02082126Medicaid
NY00762074Medicaid
NY00783028Medicaid
NYG32190Medicare UPIN
NY91N671Medicare ID - Type Unspecified
D47440Medicare UPIN
NYA59959Medicare UPIN
NY48F7921Medicare ID - Type Unspecified
NYH16816Medicare UPIN
NY02082126Medicaid
NY509871Medicare ID - Type Unspecified
NY34G041Medicare ID - Type Unspecified
NYA59831Medicare UPIN
NYS87725Medicare UPIN
NYF85172Medicare UPIN
NY2C2621Medicare ID - Type Unspecified
NY01665003Medicare ID - Type Unspecified
NY00494317Medicaid