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
25 DEGRANDPRE WAY, PLATTSBURGH, NY 12901-6449
(518) 824-2563
(833) 448-3030
Mailing address
9 CAREY RD, QUEENSBURY, NY 12804-7880
(518) 761-0300
(518) 824-2388
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
08/29/2023
Last updated
02/24/2024
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