Organization
THE PEDIATRIC SPECIALTY PRACTICES OF THE GREATER HUDSON VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC D FETHKE M.D. (DIRECTOR)
(845) 703-7000
Entity
Organization
Contact information
Practice address
75 CRYSTAL RUN RD, SUITE 102, MIDDLETOWN, NY 10941-7000
(845) 703-7000
(845) 703-0160
Mailing address
75 CRYSTAL RUN RD, SUITE 102, MIDDLETOWN, NY 10941-7000
(845) 703-7000
(845) 703-0160
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
195450-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01488655
—
NY
Enumeration date
02/01/2007
Last updated
11/24/2008
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