HUDSON HEADWATERS HEALTH NETWORK


Address: 101 Adirondack Drive, Suite 2, Ticonderoga, NY 12883
Phone: 5185856708

HUDSON HEADWATERS HEALTH NETWORK (NPI# 1952319386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952319386
Entity Type Organization
Organization Name HUDSON HEADWATERS HEALTH NETWORK
Practice Address 101 Adirondack Drive
Suite 2
Ticonderoga
NY 12883
Mailing Address 9 Carey Rd
Queensbury
NY 12804-7880
Practice Telephone 5185856708
Practice Fax Number 5185853260
Mailing Telephone 5187610300
Mailing Fax Number 5188242388
Enumeration Date 2006-08-03
Last Update Date 2020-08-20
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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 104100000X Social Worker NY Behavioral Health & Social Service Providers
N 133N00000X Nutritionist NY Dietary & Nutritional Service Providers
N 207Q00000X Family Medicine NY Allopathic & Osteopathic Physicians
N 208000000X Pediatrics NY Allopathic & Osteopathic Physicians
N 213E00000X Podiatrist NY Podiatric Medicine & Surgery Service Providers
N 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities
N 363A00000X Physician Assistant NY Physician Assistants & Advanced Practice Nursing Providers
N 363L00000X Nurse Practitioner NY Physician Assistants & Advanced Practice Nursing Providers
N 367A00000X Advanced Practice Midwife NY Physician Assistants & Advanced Practice Nursing Providers
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
NY 03289883 05

Other Provider IDs and Locations

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
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
1346263290 Hudson Headwaters Health Network Nurse Practitioner 1448 Rte 9, South Glens Falls, NY 12803 2006-07-25

Office Location

Street Address 101 ADIRONDACK DRIVE
SUITE 2
City TICONDEROGA
State NY
Zip Code 12883

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1528582822 Walgreen Co Pharmacy 1161 Nys Route 9n, Ticonderoga, NY 12883 2017-07-28
1891233540 Anne Kuhl Specialist 70 Lake George Ave, Ticonderoga, NY 12883 2017-02-02
1336697580 Hayley Jean Woods Pharmacist 1161 Nys Rte 9n, Ticonderoga, NY 12883 2016-09-16
1962776153 Linda L Leavens Counselor 166 Lord Howe St., Ticonderoga, NY 12883 2012-03-06
1093958084 Diana J Eisenberg Skilled Nursing Facility 340 Burgoyne Road, Ticonderoga, NY 12883 2009-04-07
1386765881 Dean Lewis Cook Dentist 3 Defiance St, Ticonderoga, NY 12883 2007-04-02
1902936941 Susan B Malaney Counselor 5 Defiance Street, Ticonderoga, NY 12883 2007-03-07
1023182813 Moses Ludington Hospital Pharmacy Pharmacy 1019 Wicker Street, Ticonderoga, NY 12883 2006-11-20
1336245083 Ticonderoga Emergency Squad Inc Ambulance 118 Champlain Avenue, Ticonderoga, NY 12883 2006-09-16
1649295254 Ephraim E Back Family Medicine 102 Race Track Rd Ste 1, Ticonderoga, NY 12883 2006-07-13
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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1033718085 Palliative Care Consulting Services Clinic/Center 1188 Fox St, Bronx, NY 10459-1810 2020-10-21
1821601352 Xian Medical Care PC Clinic/Center 2010 Bay Ridge Pkwy, Brooklyn, NY 11204-5925 2020-08-25
1952920795 Divine Medical LLC Clinic/Center 13163 233rd St # 1, Rosedale, NY 11422-1305 2020-04-12
1972159333 Ap Medical Care PC Clinic/Center 3506 73rd St Ste 2, Jackson Heights, NY 11372-4104 2019-08-12
1982258422 Schenk Primary Care Medicine, Pllc Clinic/Center 2350 Maple Road Suite 100, Amherst, NY 14221 2019-08-01
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
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Competitor

Search similar providers

City TICONDEROGA
Zip Code 12883

Improve Information

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Dataset Information

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.

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