Organization
TABASCO FAMILY PRACTICE PLLC
Active
Other names
tabasco health care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCINDA GROVENBURG M.D. (PRESIDENT)
(845) 626-3424
Entity
Organization
Contact information
Practice address
5 GOLDEN LN, KERHONKSON, NY 12446-1609
(845) 626-3424
(845) 626-4627
Mailing address
5 GOLDEN LN, KERHONKSON, NY 12446-1609
(845) 626-3424
(845) 626-4627
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
188450
NY
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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