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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
33 TOM PHELPS LANE, MINEVILLE, NY 12956-0480
(518) 942-7123
(518) 942-7041
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
133N00000X
Nutritionist
NY
207Q00000X
Family Medicine Physician
NY
261QF0400X
Federally Qualified Health Center (FQHC)
261QP2300X
Primary Care Clinic/Center
Primary
363A00000X
Physician Assistant
NY
363L00000X
Nurse Practitioner
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03289654
NY
Enumeration date
09/08/2006
Last updated
02/23/2024
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