# HAVERSTRAW FAMILY PRACTICE, P.C.

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

## Provider details

- **NPI number:** 1720177694
- **Authorized official:** JORGE ERNESTO LUGO M.D. (PRESIDENT)
- **Authorized official phone:** (845) 942-4512

## Contact information

- **Practice address:** 61 NEW MAIN ST, HAVERSTRAW, NY 10927-1813
- **Practice address phone:** (845) 942-4512
- **Practice address fax:** (845) 942-4514
- **Mailing address:** PO BOX 380, 61 NEW MAIN STREET, HAVERSTRAW, NY 10927-0380
- **Mailing address phone:** (845) 942-4512
- **Mailing address fax:** (845) 942-4514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 208332 | NY | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 05/07/2008