NPIMap

Organization Active NPI

Hillside Health Medical Practice, P.C.

  • Pediatrics Physician
  • Port Jervis, NY
National Provider Identifier
1124277108
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HILLSIDE HEALTH MEDICAL PRACTICE, P.C.
Practice address
123 Pike St
Suite 209
Port Jervis, NY 12771-1824
Phone
(845) 856-6671
Fax
(845) 858-9903
NPI assigned
Sep 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ecaterina Iriza, M.D.
Title
President
Phone
(845) 856-6671

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

123 Pike St
Suite 209
Port Jervis, NY 12771-1824

Mailing address

123 Pike St
Suite 209
Port Jervis, NY 12771-1824
Phone (845) 856-6671

National Provider Directory

National Provider Directory

Locations

123 Pike St
Ste 209
Port Jervis, NY 12771
Phone (845) 856-6671

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1124277108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 PIKE ST",
            "address_2": "SUITE 209",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711824",
            "telephone_number": "845-856-6671",
            "fax_number": "845-858-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 PIKE ST",
            "address_2": "SUITE 209",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711824",
            "telephone_number": "845-856-6671",
            "fax_number": "845-858-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLSIDE HEALTH MEDICAL PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "IRIZA",
        "authorized_official_first_name": "ECATERINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-856-6671",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jervis, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.