HUDSON HEADWATERS HEALTH NETWORK (NPI# 1124320247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124320247 |
| Entity Type | Organization |
| Organization Name | HUDSON HEADWATERS HEALTH NETWORK |
| Practice Address |
48 East St Fort Edward NY 12828-1811 |
| Mailing Address |
9 Carey Rd Queensbury NY 12804-7880 |
| Practice Telephone | 5188248630 |
| Practice Fax Number | 5188242302 |
| Mailing Telephone | 5187610300 |
| Mailing Fax Number | 5188242388 |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2020-01-31 |
| Authorized Official Name | CHRISTOPHER TOURNIER (EXECUTIVE VP OF FINANCE / CFO) |
| Authorized Official Telephone | 5187610300 |
| Is Organization Subpart | Y |
| Parent Organization Name | HUDSON HEADWATERS HEALTH NETWORK |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03298482 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528611084 | Hudson Headwaters Health Network | Clinic/Center | 27 Hyland Dr, Lake Luzerne, NY 12846-3923 | 2019-07-23 |
| 1780030908 | Hudson Headwaters Health Network | Clinic/Center | 1 Glen St, Glens Falls, NY 12801-4439 | 2016-05-06 |
| 1427452200 | Hudson Headwaters Health Network | Family Medicine | 353 Schroon River Rd, Warrensburg, NY 12885-4807 | 2014-10-22 |
| 1386657534 | Hudson Headwaters Health Network | Nurse Practitioner | 28 S Western Ave, Queensbury, NY 12804-3323 | 2006-08-15 |
| 1952319386 | Hudson Headwaters Health Network | Social Worker | 101 Adirondack Drive, Suite 2, Ticonderoga, NY 12883 | 2006-08-03 |
| 1073529301 | Hudson Headwaters Health Network | Dentist | 3761 Main St, Warrensburg, NY 12885-1837 | 2006-07-31 |
| 1548276801 | Hudson Headwaters Health Network | Family Medicine | 6356 Nys Route 30, Indian Lake, NY 12842-2021 | 2006-07-31 |
| 1356355952 | Hudson Headwaters Health Network | Family Medicine | 1299 Route 9, Gansevoort, NY 12831-1560 | 2006-07-28 |
| 1295758423 | Hudson Headwaters Health Network | Family Medicine | 11 Cross St, Bolton Landing, NY 12814-0539 | 2006-07-26 |
| 1609899848 | Hudson Headwaters Health Network | Social Worker | 6223 State Route 9, Chestertown, NY 12817-2823 | 2006-07-26 |
| Street Address |
48 EAST ST |
| City | FORT EDWARD |
| State | NY |
| Zip Code | 12828-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134113590 | Howard E Silverberg | Internal Medicine | 48 East St, Fort Edward, NY 12828-1811 | 2005-08-31 |
| 1730613514 | Robert Southerland | Family Medicine | 48 East St, Fort Edward, NY 12828-1811 | 2017-04-18 |
| 1376922146 | Daniela L Andrade | Social Worker | 48 East St, Fort Edward, NY 12828-1811 | 2015-05-26 |
| 1528476686 | Jacqueline Decunzo | Nurse Practitioner | 48 East St, Fort Edward, NY 12828-1811 | 2014-07-31 |
| 1003222159 | Rita Lynn All | Nurse Practitioner | 48 East St, Fort Edward, NY 12828-1811 | 2014-07-09 |
| 1790123388 | Felicia A Heber | Nurse Practitioner | 48 East St, Fort Edward, NY 12828-1811 | 2013-06-05 |
| 1750519831 | Gail E Stern | Nurse Practitioner | 48 East St, Fort Edward, NY 12828-1811 | 2009-06-26 |
| 1851530398 | Michael W Fuller | Family Medicine | 48 East St, Fort Edward, NY 12828-1811 | 2009-02-06 |
| 1124140702 | Beverly H Symonds | Social Worker | 48 East St, Fort Edward, NY 12828-1811 | 2007-04-04 |
| 1962433169 | Suzanne Hackert | Social Worker | 48 East St, Fort Edward, NY 12828-1811 | 2006-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194036772 | Theresa Anne Boire | Specialist | 270 County Route 42, Fort Edward, NY 12828 | 2010-06-29 |
| 1972838506 | Sandra Pollaro | Social Worker | 1153 Burgoyne Avenue, Hudson Falls Central School District, Fort Edward, NY 12828 | 2009-10-15 |
| 1063683845 | Barbara Elizabeth Tyler | Registered Nurse | 38 Seminary Street, Fort Edward, NY 12828 | 2008-03-19 |
| 1942386594 | Gayle J Pliscofsky | Occupational Therapist | 214 State Route 197, Fort Edward, NY 12828 | 2006-10-27 |
| 1437166626 | Moreau Emergency Squad Inc | Ambulance | 1583 State Rt 9, Fort Edward, NY 12828 | 2006-08-01 |
| 1427031319 | Fort Edward Rescue Squad Inc | Ambulance | 75 Schuyler Street, Fort Edward, NY 12828 | 2005-11-23 |
| 1639585540 | Michele Harding | Nurse Practitioner | 375 Broadway, Fort Edward, NY 12828 | 2014-07-11 |
| 1730548702 | Washington County Ofa | Public Health or Welfare | 383 Broadway, Fort Edward, NY 12828-1001 | 2016-02-18 |
| 1235365065 | Stephen Lape | Licensed Practical Nurse | 47 Park Ave, Fort Edward, NY 12828-1031 | 2009-06-08 |
| 1255697538 | Donna M Dapolito | Social Worker | 1153 Burgoyne Avenue, Suite 2, Fort Edward, NY 12828-1134 | 2012-04-11 |
| Find all providers in zip 12828 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1356993976 | Mingzhu Medical Office, P.C. | Clinic/Center | 5615 7th Ave Fl 2, Brooklyn, NY 11220-3509 | 2019-07-13 |
| 1417509357 | Henderson Health Services Family Nurse Practitioner Pllc | Clinic/Center | 4 Clarion Dr, White Plains, NY 10603-2868 | 2019-07-11 |
| 1154988897 | Bissalam Medical LLC | Clinic/Center | 3391 3rd Ave Ste 1, Bronx, NY 10456-5355 | 2019-05-28 |
| 1851859961 | Lower Westchester Medical Associates, P.C. | Clinic/Center | 105 Stevens Ave Ste 305306, Mount Vernon, NY 10550-2686 | 2019-03-07 |
| Find all providers with the same taxonomy | ||||
| City | FORT EDWARD |
| Zip Code | 12828 |
Please comment or provide details below to improve the information on HUDSON HEADWATERS HEALTH NETWORK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.