Rondout Valley Family Med Pc

LBN: Rondout Valley Family Med Pc
Rondout Valley Family Med Pc is an health care organization with primary practice located at 10 Gagnon Dr , Stone Ridge NY 12484-5120. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Rondout Valley Family Med Pc can be contacted via phone (845) 687-9933, or through Petrulis, Peter James via phone (845) 687-9933.

Contact Information

Primary practice address
10 Gagnon Dr Stone Ridge NY 12484-5120
Phone: (845) 687-9933
Fax: (845) 687-9953
Website:
Map and Directions
Authorized official contact:
Name: Petrulis, Peter James Doctor of Osteopathy (DO)
Phone: (845) 687-9933

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 160527 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 008467-1 New York

Profile Details

NPI number 1679514004
LBN Legal business name Rondout Valley Family Med Pc
DBA Doing business as
Authorized official Petrulis, Peter James Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 9th, 2006
Last updated Oct 9th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679514004 NPPES
New York Other 10031715 CDPHN
New York Other 87726 CDPHN
New York MEDICAID 00950523 CDPHN
New York Other 3292 CDPHN

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