| New Windsor Family Care Llc | |
|
377 Broadway Newburgh NY 12550-5301 | |
| (845) 562-2191 | |
| Not Available |
| Full Name | New Windsor Family Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 377 Broadway, Newburgh, New York |
| Authorized Official Name and Position | Minoo Pedeom-shapiro (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8455622191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Windsor Family Care Llc 377 Broadway Newburgh NY 12550-5301 Ph: (845) 562-2191 | New Windsor Family Care Llc 377 Broadway Newburgh NY 12550-5301 Ph: (845) 562-2191 |
| NPI Number | 1669192712 |
|---|---|
| Provider Enumeration Date | 08/30/2022 |
| Last Update Date | 01/23/2023 |
| Medicare PECOS PAC ID | 5597137067 |
|---|---|
| Medicare Enrollment ID | O20230209000957 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669192712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Minoo Pedoem-shapiro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780678136 PECOS PAC ID: 4082832878 Enrollment ID: I20140819002288 |
| Provider Name | Christine Vega-ruscher |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1427452267 PECOS PAC ID: 7810318672 Enrollment ID: I20200602002977 |
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