| Columbia Memorial Hospital | |
|
71 Prospect Avenue Dental Program Hudson NY 12534 | |
| (518) 669-7892 | |
| (518) 669-7893 |
| Full Name | Columbia Memorial Hospital |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 71 Prospect Avenue, Hudson, New York |
| Authorized Official Name and Position | Vicent J Dingman (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5188288249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Memorial Hospital 71 Prospect Ave Hudson NY 12534-2907 Ph: (518) 669-7892 | Columbia Memorial Hospital 71 Prospect Avenue Dental Program Hudson NY 12534 Ph: (518) 669-7892 |
| NPI Number | 1215265517 |
|---|---|
| Provider Enumeration Date | 11/24/2009 |
| Last Update Date | 11/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215265517 | NPI | - | NPPES |
| 00335915 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1001000H (New York) | Primary |
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