HUDSON HEADWATERS HEALTH NETWORK (NPI# 1811367170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811367170 |
| Entity Type | Organization |
| Organization Name | HUDSON HEADWATERS HEALTH NETWORK |
| Practice Address |
118 Broad St Glens Falls NY 12801-4348 |
| Mailing Address |
9 Carey Rd Queensbury NY 12804-7880 |
| Practice Telephone | 5187922223 |
| Practice Fax Number | 5186362077 |
| Mailing Telephone | 5187610300 |
| Mailing Fax Number | 5188242388 |
| Enumeration Date | 2015-09-30 |
| 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 |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 04280466 | 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 |
118 BROAD ST |
| City | GLENS FALLS |
| State | NY |
| Zip Code | 12801-4348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487101101 | Trudy Marie-viola Phillips | Nurse Practitioner | 118 Broad St, Glens Falls, NY 12801-4348 | 2016-09-11 |
| 1275551392 | Katy L Fuller | Social Worker | 118 Broad St, Glens Falls, NY 12801-4348 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629549399 | Upstate Vision Care, Pllc | Technician/Technologist | 206 Glen St. Suite 31b, Colvin Building, Glens Falls, NY 12801 | 2018-12-06 |
| 1043737356 | Tiffany Britt | Social Worker | 43 Kensington Rd, Glens Falls, NY 12801 | 2017-08-28 |
| 1922375922 | Kathleen A Callaghan | Registered Nurse | 43 Kensington Road, Glens Falls, NY 12801 | 2011-11-19 |
| 1043595531 | Nancy K. Carroll | Social Worker | 37 Broad St., Glens Falls, NY 12801 | 2011-10-15 |
| 1992027528 | Benjamin Alan Rametta | Pharmacist | 202 Broad Street, Walgreens, Glens Falls, NY 12801 | 2010-02-23 |
| 1194052563 | Angela M Lalla | Audiologist | 318 Ridge Street, Glens Sallas, NY 12801 | 2009-11-05 |
| 1407018591 | Marilyn J Bryan | Counselor | 4 Technical Park, Suite #3, #6, Glens Falls, NY 12801 | 2008-06-30 |
| 1104087667 | Chase Chiropractic LLC | Chiropractor | 17 Pine St. 1 Irongate Center, Suite 3, Glens Falls, NY 12801 | 2008-06-18 |
| 1619183571 | Glens Falls Crossings LLC | Skilled Nursing Facility | 170 Warren Street, Glens Falls, NY 12801 | 2007-05-15 |
| 1417099706 | Patricia Ann Cameron | Psychologist | 464 Glen Street, Glens Falls, NY 12801 | 2007-02-13 |
| Find all providers in zip 12801 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1962040246 | Community Health Project Inc. | Clinic/Center | 40 Flatbush Avenue Extension, Brooklyn, NY 11201 | 2019-12-17 |
| 1245886753 | Care for The Homeless | Clinic/Center | 91 Junius St, Brooklyn, NY 11212-8021 | 2019-08-12 |
| 1184186496 | Oda Primary Health Care Network, Inc. | Clinic/Center | 74 Wallabout Street, Brooklyn, NY 11249 | 2019-04-04 |
| 1538621289 | Ezras Choilim Health Center, Inc. | Clinic/Center | 49 Forest Rd Fl 3, Monroe, NY 10950-2923 | 2019-04-02 |
| 1134693708 | Rochester Primary Care Network, Inc | Clinic/Center | 3 Parkside Ct Bldg 1, Utica, NY 13501-5643 | 2019-01-17 |
| 1164994190 | Morris Heights Health Center, Inc. | Clinic/Center | 1 W Burnside Ave, Bronx, NY 10453-4003 | 2019-01-02 |
| Find all providers with the same taxonomy | ||||
| City | GLENS FALLS |
| Zip Code | 12801 |
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.