# HAVERSTRAW PEDIATRICS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033248562
- **Authorized official:** VIDHU THAKER M.D. (PARTNER)
- **Authorized official phone:** (845) 429-3382

## Contact information

- **Practice address:** 48 NEW MAIN ST, HAVERSTRAW, NY 10927-1812
- **Practice address phone:** (845) 429-3382
- **Practice address fax:** (845) 429-2057
- **Mailing address:** 48 NEW MAIN ST, HAVERSTRAW, NY 10927-1812
- **Mailing address phone:** (845) 429-3382
- **Mailing address fax:** (845) 429-2057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 109077 | NY | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 129096 | NY | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 136434 | NY | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 227354 | NY | — |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 08/22/2020