# HEALTH QUEST MEDICAL PRACTICE, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Modena PCP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992190722
- **Authorized official:** RONALD TATELBAUM MD (PRESIDENT)
- **Authorized official phone:** (845) 475-9635

## Contact information

- **Practice address:** 2044 ROUTE 32, SUITE4, MODENA, NY 12548
- **Practice address phone:** (845) 883-5176
- **Practice address fax:** (845) 883-5177
- **Mailing address:** 1351 ROUTE 55, SUITE 200, LAGRANGEVILLE, NY 12540-5108
- **Mailing address phone:** (845) 475-9661
- **Mailing address fax:** (845) 475-9938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/30/2015
- **Last updated:** 03/30/2015