Organization
MOSES-LUDINGTON HOSPITAL
Active
Other names
Inter-Lakes Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN HAUGHNEY (CEO)
(518) 585-3719
Entity
Organization
Contact information
Practice address
1019 WICKER ST, TICONDEROGA, NY 12883
(518) 585-3700
(518) 585-2576
Mailing address
1019 WICKER ST, TICONDEROGA, NY 12883-1039
(518) 585-3700
(518) 585-2576
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
1564701C
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000400017000
BLUESHIELD OF NENY
NY
01
—
000932
EMPIRE BLUE CROSS
NY
05
—
00360930
—
NY
01
—
330116
EXCELLUS BLUE CROSS
NY
Enumeration date
08/25/2005
Last updated
06/22/2018
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