Organization
HAVERSTRAW PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIDHU THAKER M.D. (PARTNER)
(845) 429-3382
Entity
Organization
Contact information
Practice address
48 NEW MAIN ST, HAVERSTRAW, NY 10927-1812
(845) 429-3382
(845) 429-2057
Mailing address
48 NEW MAIN ST, HAVERSTRAW, NY 10927-1812
(845) 429-3382
(845) 429-2057
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
109077
NY
2080A0000X
Pediatric Adolescent Medicine Physician
129096
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
136434
NY
2080A0000X
Pediatric Adolescent Medicine Physician
227354
NY
Other
Enumeration date
03/02/2007
Last updated
08/22/2020
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