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
28 S WESTERN AVE, QUEENSBURY, NY 12804-3323
(518) 798-6400
(518) 798-4105
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
—
NY
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03289663
—
NY
Enumeration date
08/15/2006
Last updated
02/23/2024
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