HAVERSTRAW FAMILY PRACTICE P.C. NPI 1720177694

NPI Information

NPI: 1720177694
Provider Name: HAVERSTRAW FAMILY PRACTICE, P.C.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
61 NEW MAIN ST
HAVERSTRAW, NY
ZIP 10927
Phone: (845) 942-4512
Get Directions

HAVERSTRAW FAMILY PRACTICE, P.C. is a family medicine in Haverstraw, NY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. HAVERSTRAW FAMILY PRACTICE, P.C. NPI is 1720177694. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

61 NEW MAIN ST
HAVERSTRAW, NY
ZIP 10927-813
Phone: (845) 942-4512
Fax: (845) 942-4514

The provider's authorized official is Jorge Ernesto Lugo .
The authorized official title is President and has the following contact phone number (845) 942-4512.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 5/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		208332	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	393729	OTHER	NEW YORK	MVP
2	134973	OTHER	NEW YORK	AETNA
3	172321P	OTHER	NEW YORK	HIP
4	005720	OTHER	NEW YORK	COMMUNITY CHOICE
5	1000000194	OTHER	NEW YORK	AFFINITY
6	46V621	OTHER	NEW YORK	EMPIRE BC/BS
7	4C5847	OTHER	NEW YORK	HEALTHNET
8	W5W341	MEDICARE PIN	NEW YORK
9	G94346	MEDICARE UPIN	NEW YORK
10	01814819	MEDICAID	NEW YORK
11	040426012056	OTHER	NEW YORK	FIDELIS
12	5997592	OTHER	NEW YORK	GHI
13	P2543357	OTHER	NEW YORK	OXFORD
14	221824	OTHER	NEW YORK	WELLCARE
15	396995	OTHER	NEW YORK	CONNECTICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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