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Organization
HERITAGE MEDICAL GROUP, LLP
Active
Organization
HERITAGE MEDICAL GROUP, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE O'DONNELL (PRACTICE MANAGER)
(914) 631-2070
Entity
Organization
Contact information
Practice address
362 N BROADWAY FL 2, SLEEPY HOLLOW, NY 10591-2310
(914) 631-2070
(914) 631-0797
Mailing address
362 N BROADWAY FL 2, SLEEPY HOLLOW, NY 10591-2310
(914) 631-2070
(914) 631-0797
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Enumeration date
08/23/2006
Last updated
04/20/2008
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