Organization
HUDSON HEADWATERS HEALTH NETWORK
Active
Parent organization
HUDSON HEADWATERS HEALTH NETWORK
Organization subpart
Yes
Provider details
NPI number
Legal business name
HUDSON HEADWATERS HEALTH NETWORK
Authorized official
LAURA PASCO (EXECUTIVE VP, CFO)
(518) 761-0300
Entity
Organization
Contact information
Practice address
48 EAST ST, FORT EDWARD, NY 12828-1811
(518) 824-8630
(518) 824-2302
Mailing address
9 CAREY RD, QUEENSBURY, NY 12804-7880
(518) 761-0300
(518) 824-2388
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
213E00000X
Podiatrist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
364SF0001X
Family Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03298482
—
NY
Enumeration date
11/22/2010
Last updated
02/23/2024
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