Organization
MID-HUDSON OPHTHALMOLOGICAL RETINA CONSULTANTS, PLLC
Active
Other names
MID-HUDSON RETINA CONSULTANTS, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN M LOCICERO (OFFICE MANAGER)
(845) 692-0834
Entity
Organization
Contact information
Practice address
450 GIDNEY AVE, NEWBURGH, NY 12550-3116
(845) 562-1100
(845) 562-1162
Mailing address
450 GIDNEY AVE, NEWBURGH, NY 12550-3116
(845) 562-1100
(845) 562-1162
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
149190
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00718525
—
NY
01
—
149190-1
LICENSE
NY
01
—
192875-2
LICENSE
NY
Enumeration date
11/29/2006
Last updated
04/03/2017
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