NPIMap

Sun River Health Inc.

Organization Active NPI Federally Qualified Health Center (FQHC) · Peekskill, NY

NPI 1619969458 · NPPES record last updated Mar 11, 2022

Key facts

NPI
1619969458
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
SUN RIVER HEALTH INC.
Practice address
1037 Main St
Hudson River Healthcare, Inc.
Peekskill, NY 10566-2913
Phone
(914) 734-8800
Fax
(914) 734-8786
NPI assigned
Aug 18, 2005
Organization subpart
Yes
Parent organization (as reported)
SUN RIVER HEALTH INC.

Authorized official

Name
Adam Lipton
Title
VP Info/Practice MGMT Systems
Phone
(914) 384-2375

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Facilities connected through Provider of Services related, parent or unit certification numbers.

Practitioners 687

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

View all 687

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D0006905Sun River Health Peekskill
1037 Main Street, Peekskill, NY 10566		Certificate of waiverMar 26, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (46 enrollments) in NY, CT

Federally qualified health center certification: CCN 331916

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 6, 2002
Last certification
Sep 6, 2002
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
75 Washington St
Poughkeepsie, NY 12601-2303

Federally qualified health center certification: CCN 331829

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1992
Last certification
Jan 1, 1992
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
1037 Main St
Peekskill, NY 10566-2913

Federally qualified health center certification: CCN 331871

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
888 Pulaski Hwy
Goshen, NY 10924-6034

Federally qualified health center certification: CCN 331872

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 1, 1992
Last certification
Feb 1, 1992
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
6 Henry St
Beacon, NY 12508-3058

Federally qualified health center certification: CCN 331902

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 30, 2001
Last certification
Aug 30, 2001
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
29 N Hamilton St
Poughkeepsie, NY 12601-2541

Federally qualified health center certification: CCN 331904

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 30, 2001
Last certification
Aug 30, 2001
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
3174 Route 22
Dover Plains, NY 12522-5924

Federally qualified health center certification: CCN 331905

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 30, 2001
Last certification
Aug 30, 2001
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
3360 Route 343
Amenia, NY 12501-5619

Federally qualified health center certification: CCN 331903

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 30, 2001
Last certification
Aug 30, 2001
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
75 Orange Ave
Walden, NY 12586-1816

Federally qualified health center certification: CCN 331972

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 7, 2007
Last certification
Dec 7, 2007
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
327 Front St
Greenport, NY 11944-1515

Federally qualified health center certification: CCN 331973

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 7, 2007
Last certification
Dec 7, 2007
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
31 W Broad St
FL 3
Haverstraw, NY 10927-1615

Federally qualified health center certification: CCN 331974

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 7, 2007
Last certification
Dec 7, 2007
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
1 Paradies LN
New Paltz, NY 12561-4031

Federally qualified health center certification: CCN 331975

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 7, 2007
Last certification
Dec 7, 2007
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
23 Lakewood Ave
Monticello, NY 12701-2021

Federally qualified health center certification: CCN 331000

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 13, 2009
Last certification
Apr 13, 2009
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
2 Park Ave
Yonkers, NY 10703-3402

Federally qualified health center certification: CCN 331989

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 13, 2009
Last certification
Apr 13, 2009
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
503 S Broadway
Ste 210
Yonkers, NY 10705-6202

Federally qualified health center certification: CCN 331053

Legal name
SUN RIVER HEALTH INC.
Doing business as
HUDSON RIVER HEATLHCARE INC - SPRING VALLEY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 29, 2012
Last certification
Jun 29, 2012
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
2 Perlman Dr
Spring Valley, NY 10977-5245

Federally qualified health center certification: CCN 331048

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 26, 2012
Last certification
Jul 26, 2012
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
82 Middle Country Rd
Coram, NY 11727-4460

Federally qualified health center certification: CCN 331108

Legal name
SUN RIVER HEALTH INC.
Doing business as
SUN RIVER HEALTH SOUTHAMPTON
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 16, 2014
Last certification
Apr 16, 2014
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
330 Meeting House LN
Ste 1
Southampton, NY 11968-5064

Federally qualified health center certification: CCN 331112

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 18, 2014
Last certification
Jun 18, 2014
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
750 Union St
Hudson, NY 12534-3002
Related CCNs
331853

Federally qualified health center certification: CCN 331116

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 29, 2014
Last certification
Sep 29, 2014
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
1080 Sunrise Hwy
Amityville, NY 11701-2526
Related CCNs
331972

Federally qualified health center certification: CCN 331120

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 16, 2014
Last certification
Oct 16, 2014
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
1556 Straight Path
Wyandanch, NY 11798-3213

Federally qualified health center certification: CCN 331134

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 6, 2015
Last certification
Jan 6, 2015
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
501 N Ocean Ave
Patchogue, NY 11772-1758

Federally qualified health center certification: CCN 331137

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 30, 2015
Last certification
Jan 30, 2015
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
550 Montauk Hwy
Shirley, NY 11967-2114
Related CCNs
331916

Federally qualified health center certification: CCN 331166

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 9, 2015
Last certification
Sep 9, 2015
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
1869 Brentwood Rd
Brentwood, NY 11717-4625

Federally qualified health center certification: CCN 331176

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 23, 2015
Last certification
Nov 23, 2015
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
300 Center Dr
Riverhead, NY 11901-3393

Federally qualified health center certification: CCN 571007

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 13, 2016
Last certification
Sep 13, 2016
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
84 N Highland Ave
Nyack, NY 10960-1831

Federally qualified health center certification: CCN 571049

Legal name
SUN RIVER HEALTH INC.
Doing business as
HRHCARE MIDDLETOWN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 21, 2016
Last certification
Nov 21, 2016
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
24 Union St
Middletown, NY 10940-4906

Federally qualified health center certification: CCN 571158

Legal name
SUN RIVER HEALTH INC.
Doing business as
SUN RIVER HEALTH QUEENS HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2019
Last certification
Feb 14, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
10504 Sutphin Blvd
Jamaica, NY 11435-5022

Federally qualified health center certification: CCN 571166

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 4, 2019
Last certification
Feb 4, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
2510 Westchester Ave
Ste 202
Bronx, NY 10461-3585

Federally qualified health center certification: CCN 571156

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2019
Last certification
Feb 14, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
1543-1545 Inwood Ave
Bronx, NY 10452-2001

Federally qualified health center certification: CCN 571155

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 4, 2019
Last certification
Feb 4, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
2400 Linden Blvd
Brooklyn, NY 11208-4830

Federally qualified health center certification: CCN 571159

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2019
Last certification
Feb 14, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
56 Bay St
FL 6
Staten Island, NY 10301-2563

Federally qualified health center certification: CCN 571167

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 4, 2019
Last certification
Feb 4, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
1669 Bedford Ave
Brooklyn, NY 11225-2009

Federally qualified health center certification: CCN 571160

Legal name
SUN RIVER HEALTH INC.
Doing business as
SUN RIVER HEALTH SIDNEY R. BAER, JR.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 14, 2019
Last certification
Feb 14, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
347 W 37TH St
New York, NY 10018-4202

Federally qualified health center certification: CCN 571152

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 28, 2019
Last certification
Jan 28, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
459 E 149TH St
Ste 202
Bronx, NY 10455-1789

Federally qualified health center certification: CCN 571151

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 28, 2019
Last certification
Jan 28, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
57 Bay St
Staten Island, NY 10301-2510

Federally qualified health center certification: CCN 571154

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 28, 2019
Last certification
Jan 28, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
2412 Church Ave
Brooklyn, NY 11226-4005

Federally qualified health center certification: CCN 571188

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 15, 2019
Last certification
Mar 15, 2019
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
55 Horizon Dr
Huntington, NY 11743-4436

Federally qualified health center certification: CCN 331802

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 23, 2022
Last certification
Dec 23, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
11020 Jamaica Ave
Richmond Hill, NY 11418-2324

Federally qualified health center certification: CCN 331055

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 23, 2022
Last certification
Dec 23, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
4377 Bronx Blvd
Bronx, NY 10466-1397

Federally qualified health center certification: CCN 331800

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 23, 2022
Last certification
Dec 23, 2022
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
820 Saint Anns Ave
Bronx, NY 10456-7885

Federally qualified health center certification: CCN 331828

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 27, 2023
Last certification
Sep 27, 2023
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
445 Oak St
Ste 201
Copiague, NY 11726-3111

Federally qualified health center certification: CCN 571879

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 9, 2024
Last certification
Oct 9, 2024
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
360 Mamaroneck Ave
# 1
White Plains, NY 10605-1700

Federally qualified health center certification: CCN 571877

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 9, 2024
Last certification
Oct 9, 2024
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Incorporated
Aug 5, 1975 in NY
Enrollment address
14 Lawton St
# 1
New Rochelle, NY 10801-6349

Federally qualified health center certification: CCN 571907

Legal name
SUN RIVER HEALTH INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 30, 2025
Last certification
Apr 30, 2025
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
2351 Bedford Ave
Brooklyn, NY 11226-5403

All disclosed owners & managing parties 30

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gabriela Vega Matthews
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Corporate Officer
Board Member		 Jan 1, 2024
Andrew S Richter
Individual 		Corporate Officer
Board Member Treasurer		 Jan 1, 1999 100%
Corporate Director
Board Member		 Jan 1, 1999
Corporate Director
Board Member/Treasurer		 Jan 1, 1999
Corporate Officer Jan 1, 1999
Corporate Officer
Board Member - Treasurer		 Jan 1, 1999 100%
Corporate Officer
Board Member		 Jan 1, 1999 100%
Corporate Director
Board Member Treasurer		 Jan 1, 1999
Corporate Officer
Board Member-Treasurer		 Jan 1, 2009 100%
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member/Treasurer		 Jan 1, 1979
Corporate Officer
Board Member		 Jan 1, 2009 100%
Corporate Officer
Treasurer		 Jan 1, 1999 100%
Corporate Director
Board Member		 Jan 1, 2023
Corporate Officer
Board Member/Treasurer		 Jan 1, 1977 100%
Corporate Officer
Board Member		 Jan 1, 1999
Berthilde Dufrene
Individual 		Corporate Director
Board Member		 Jan 1, 2020
Corporate Officer
Board Member		 Jan 1, 2020
Corporate Director
Board Member		 Jan 1, 2017
Corporate Officer
Board Member		 Jan 1, 2017 100%
Corporate Officer
Board Member		 Jan 1, 2017
Corporate Officer
Board Member		 Jan 1, 2004 100%
Corporate Officer
Board Member		 Jan 1, 2020 100%
Michael Smith
Individual 		Corporate Director
Board Member		 Jan 1, 2004
Corporate Director
Board Member		 Jan 1, 2019
Corporate Director
Board Member		 Jan 1, 2024
Corporate Officer
Board Member		 Jan 1, 2024
Corporate Director
Board Member		 Jan 1, 2012
Luke Hilpert
Individual 		Corporate Officer
Board Member-Secretary		 Jan 1, 2007 100%
Corporate Director
Board Member		 Jan 1, 2007
Corporate Officer Jan 1, 2007
Corporate Officer
Board Member- Secretary		 Jan 1, 2007 100%
Corporate Officer
Board Member		 Jan 1, 2007 100%
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Officer
Board Member		 Jan 1, 2012 100%
Corporate Officer
Secretary		 Jan 1, 2007 100%
Corporate Director
Board Member		 Jan 1, 2023
Corporate Officer
Board Member/Secretary		 Jan 1, 2007 100%
Corporate Officer
Board Member/Secretary		 Jan 1, 2007
Marcia Jacobowitz-Paz
Individual 		Corporate Officer
Board Member-Vice Chairperson		 Jan 1, 1999 100%
Corporate Director
Board Member		 Jan 1, 1999
Corporate Officer Jan 1, 1999
Corporate Officer
Board Member Vice Chairperson		 Jan 1, 1999 100%
Corporate Officer
Board Member		 Jan 1, 1999 100%
Corporate Director
Board Member Vice Chaiperson		 Jan 1, 1999
Corporate Director
Board Member		 Jan 1, 1999 100%
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member/Vice Chair		 Jan 1, 1999
Corporate Officer
Board Memner		 Jan 1, 1999 100%
Corporate Director
Board Member Vice Chairperson		 Jan 1, 1999
Corporate Officer
Vice Chairperson		 Jan 1, 1999 100%
Corporate Director
Board Member		 Jan 1, 2023
Corporate Officer
Board Member/Vice Chairperson		 Jan 1, 1999 100%
Corporate Director
Board Member		 Jan 1, 2019
Corporate Officer
Board Member/Vice Chairperson		 Jan 1, 1999
Corporate Officer
Board Member		 Jan 1, 1999
Angela Earl
Individual 		Corporate Officer
Board Member		 Jan 1, 2013 100%
Corporate Director
Board Member		 Jan 1, 2013
Corporate Officer Jan 1, 2013
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member		 Jan 1, 2023
Corporate Director Jan 1, 2013
Corporate Officer
Board Member		 Jan 1, 2013
Norma Johnson
Individual 		Corporate Officer
Board Member-Vice Chair Person		 Jan 1, 1977 100%
Corporate Director
Board Member		 Jan 1, 1997
Corporate Director
Board Member/Vice Chair		 Jan 1, 1997
Corporate Officer Jan 1, 1977
Corporate Officer
Board Member Vice C Hairperson		 Jan 1, 1977 100%
Corporate Officer
Board Member		 Jan 1, 1977 100%
Corporate Director
Board Member Vice Chaiperson		 Jan 1, 1977
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member/Vice Chair		 Jan 1, 1977
Corporate Officer
Vice Chairperson		 Jan 1, 1977 100%
Corporate Officer
Board Member/Vice Chair Person		 Jan 1, 1977 100%
Corporate Director
Board Member Vice Chairperson		 Jan 1, 1977
Corporate Officer
Vice Chairperson		 Jan 1, 1997 100%
Corporate Director
Board Member		 Jan 1, 1977
Corporate Director
Board Member		 Jan 1, 2023
Corporate Director
Board Member		 Jan 1, 2019
Corporate Officer
Board Member		 Jan 1, 1977
Charles Miller
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member		 Dec 1, 2019
Corporate Officer
Board Member		 Jan 1, 2019
Corporate Officer
Board Member		 Jan 1, 2019 100%
Emma McKinney
Individual 		Corporate Officer
Credentialing Supervisor		 Nov 15, 2018 100%
W-2 Managing Employee
Credentialing Supervisor		 Nov 15, 2018 100%
W-2 Managing Employee
Credentialing Supervisor		 Mar 28, 2018
Corporate Officer
Delegated Official		 Nov 15, 2018
W-2 Managing Employee
Supervisor of Credentialing		 Aug 29, 2005
Corporate Officer
Delegated Official		 Jan 4, 2026
W-2 Managing Employee
Credentialing Supervisor		 Aug 29, 2003
Corporate Officer
Delegated Official		 Nov 15, 2018 100%
Corporate Officer
Supervisor of Credentialing		 May 15, 2025
W-2 Managing Employee
Supervisor of Credentialing		 Aug 29, 2003
W-2 Managing Employee
Supervisor of Credentialing		 Jan 10, 2010
Corporate Officer
Supervisor of Credentialing		 Jan 1, 2018
Corporate Director
Supervisor of Credentialing		 Jan 1, 2018
W-2 Managing Employee
Supervisor of Credentialing		 Jan 1, 2018 100%
Corporate Officer
Credentialing Supervisor		 Jan 1, 2018 100%
W-2 Managing Employee
Credentialing Supervisor		 Jan 1, 2018 100%
Corporate Officer
Credentialing Specialist		 Jan 1, 2018 100%
W-2 Managing Employee
Credentialing Specialist		 Jan 1, 2018 100%
W-2 Managing Employee
Supervisor of Credentialing		 Aug 29, 2003 100%
Corporate Officer
Delegated Official		 Mar 28, 2018
Corporate Officer
Supervisor of Credentialing		 Dec 28, 2018 100%
Alan L Steiner
Individual 		Corporate Officer
Board Member-Chairman		 Jan 1, 1979 100%
Corporate Director
Board Member		 Jan 1, 1979
Corporate Director
Board Member/ Chair		 Jan 1, 1979
Corporate Officer Jan 1, 1979
Corporate Officer
Board Member Chairman		 Jan 1, 1979 100%
Corporate Officer
Board Member		 Jan 1, 1979 100%
Corporate Director
Board Member Chairperson		 Jan 1, 1979
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member - Chairperson		 Jan 1, 1979
Corporate Officer
Board Member - Chariman		 Jan 1, 1979 100%
Corporate Officer
Chairman		 Jan 1, 1979 100%
Corporate Director
Board Member		 Jan 1, 1999
Corporate Director
Board Member		 Jan 1, 2023
Corporate Officer Jan 1, 1979 100%
Corporate Officer
Board Member		 Jan 1, 1979
Corporate Officer
Board Member/Chairperson		 Jan 1, 1979 100%
James D. Sinkoff
Individual 		Corporate Officer
Senior Vice President/Chief Fina		 Jan 10, 2010 100%
W-2 Managing Employee
Senior Vice President/Chief Fina		 Jan 10, 2010 100%
Corporate Officer
Sr. Vice President, Cfo		 Jan 10, 2010
W-2 Managing Employee
Sr. Vice President, Cfo		 Jan 10, 2010 100%
Corporate Officer
Sr Vice President/Chief Financia		 Jan 10, 2010 100%
W-2 Managing Employee
Sr Vice President/Chief Financia		 Jan 10, 2010 100%
Corporate Officer
Cfo		 Jan 10, 2010 100%
W-2 Managing Employee Jan 10, 2010
Corporate Officer
Senior Vice President/ Chief Fin		 Jan 10, 2010 100%
W-2 Managing Employee
Senior Vice President / Chief Fi		 Jan 10, 2010 100%
Corporate Officer
Sr. Vice President, Cfo		 Jan 10, 2010 100%
Corporate Officer
Deo & Cfo		 Jan 10, 2010 100%
W-2 Managing Employee
Deo and Cfo		 Jan 10, 2010 100%
Corporate Officer
Deo and Cfo		 Jan 10, 2010 100%
Corporate Officer
Deo and Cfo		 Mar 1, 2022 100%
W-2 Managing Employee
Deo and Cfo		 Jan 1, 2010 100%
Corporate Officer
Deo & Cfo		 Jan 10, 2010
W-2 Managing Employee
Deo and Cfo		 Jan 10, 2010
Corporate Officer
Sr. VP/Chief Financial Officer		 Jan 10, 2010 100%
W-2 Managing Employee
Sr. VP/Chief Financial Officer		 Jan 10, 2010 100%
Corporate Officer
SVP		 Jan 10, 2010 100%
W-2 Managing Employee
SVP		 Jan 10, 2010 100%
Corporate Officer
Senior VP/Cfo		 Jan 10, 2010 100%
W-2 Managing Employee
Senior VP/Cfo		 Jan 10, 2010 100%
Corporate Officer
Senior Vice Presicent/ Cfo		 Jan 10, 2010 100%
W-2 Managing Employee
Senior Vice Presicent/ Cfo		 Jan 10, 2010 100%
W-2 Managing Employee
Senior Vice President/ Cfo		 Jan 10, 2010 100%
Corporate Officer
Deo & Cfo		 Jan 1, 2010
W-2 Managing Employee
Deo & Cfo		 Jan 10, 2010
W-2 Managing Employee
Sr. VP/Cfo		 Jan 10, 2010 100%
Corporate Officer
Sr VP/Chief Financial Officer		 Jan 10, 2010 100%
W-2 Managing Employee
Sr VP/Chief Financial Officer		 Jan 10, 2010 100%
Corporate Officer
Deo and Cfo		 Jan 10, 2010
Corporate Officer
Sr Vice President/Chief Financi		 Jan 10, 2010 100%
W-2 Managing Employee
Sr Vice President/Chief Financi		 Jan 10, 2010 100%
Corporate Officer
Sr. Vice President/Chief Financi		 Jan 10, 2010 100%
W-2 Managing Employee
Sr. Vice President/Chief Financi		 Jan 10, 2010 100%
Corporate Director
Deo & Cfo		 Jan 10, 2020
Corporate Officer
Deputy Executive Officer		 Jan 10, 2010 100%
W-2 Managing Employee
Deputy Executive Officer		 Jan 10, 2010 100%
W-2 Managing Employee
Deputy Executive Officer		 Jan 1, 2010 100%
Corporate Officer
Deputy Executive Officer		 Oct 10, 2010 100%
W-2 Managing Employee
Deputy Executive Officer		 Oct 10, 2010 100%
Corporate Director
Deo and Cfo		 Jan 10, 2010
Corporate Officer
Deo and Cfo		 Jan 1, 2013
W-2 Managing Employee
Deo and Cfo		 Jan 10, 2012
Corporate Officer
Deo & Cfo		 Sep 7, 2018 100%
W-2 Managing Employee
Deo & Cfo		 Jan 10, 2010 100%
Corporate Officer
Authorized Official		 Jan 1, 2013
W-2 Managing Employee
Deo/Cfo		 Jan 10, 2012
Corporate Officer
Dceo/Chief Financial Officer		 Jan 10, 2010
W-2 Managing Employee
Dceo/Chief Financial Officer		 Jan 10, 2010
Deeptha Nedunchezian
Individual 		Corporate Director
Board Member		 Jan 1, 2021
Corporate Officer
Board Member		 Jan 1, 2021
Corporate Director
Board Member		 Jan 1, 2019
Aubrey Saunders
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Officer
Board Member		 Jan 1, 2019
Corporate Officer
Board Member		 Jan 1, 2019 100%
John Russell
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Officer
Board Member		 Jan 1, 2019
Corporate Officer
Board Member		 Jan 1, 2019 100%
Adam K Lipton
Individual 		Corporate Officer
Vice President of Practice Manag		 Sep 14, 2009 100%
W-2 Managing Employee
100		 Sep 14, 2009
Corporate Officer
VP of Practice Management and in		 Sep 14, 2009 100%
W-2 Managing Employee
VP Info/Practice Management Systems		 Sep 14, 2009 100%
Corporate Officer
VP Practice Management & Informa		 Sep 14, 2009 100%
W-2 Managing Employee
VP Practice Management & Informa		 Sep 14, 2009 100%
Corporate Officer
VP of Practice MGMT and Information		 Sep 14, 2009
W-2 Managing Employee
VP of Information and Practice MGMT		 Sep 14, 2009
W-2 Managing Employee
Vice President of Practice Manag		 Sep 14, 2009 100%
W-2 Managing Employee
VP Practice Management & Informa		 Sep 17, 2007 100%
W-2 Managing Employee
VP of Practice Management and in		 Sep 14, 2009 100%
Corporate Officer
VP Practice MGMT & Information		 Jul 7, 2007 100%
W-2 Managing Employee
VP Practice MGMT & Information		 Jul 2, 2007 100%
W-2 Managing Employee
VP Practice Management & Informa		 Oct 5, 2007 100%
Corporate Officer
VP of Practice MGMT and Information		 Sep 14, 2008
Corporate Officer
VP of Information/Practice MGMT		 Mar 1, 2022 100%
W-2 Managing Employee
VP of Information /Practice MGMT		 Sep 14, 2009 100%
Corporate Officer
VP Practice MGMT & Information		 Jul 7, 2007
W-2 Managing Employee
VP Practice Management & Informa		 Sep 14, 2009
Corporate Officer
VP		 Sep 14, 2009 100%
W-2 Managing Employee
VP		 Sep 14, 2009 100%
Corporate Officer
VP of Practice Managment		 Sep 14, 2009 100%
W-2 Managing Employee
VP of Practice Managment		 Sep 14, 2009 100%
Corporate Officer
Vice President of Practice MGMT		 Sep 14, 2009 100%
W-2 Managing Employee
Vice President of Practice MGMT		 Sep 14, 2009 100%
Corporate Officer
VP of Information/Practice MGMT		 Sep 14, 2009 100%
W-2 Managing Employee
VP of Information/Practice MGMT		 Sep 14, 2009 100%
Corporate Officer
VP of Practice Management & Info		 Sep 14, 2009 100%
W-2 Managing Employee
VP of Practice Management & Info		 Sep 14, 2009 100%
Corporate Officer
VP Practice MGMT & Information		 Sep 14, 2009
W-2 Managing Employee
VP Practice MGMT & Information		 Sep 14, 2009
Corporate Officer
VP of Practice Management & Info		 Sep 14, 2009
Corporate Officer
VP of Information and Practice M		 Sep 14, 2009
Corporate Director
VP of Information & Practice MGMT		 Sep 14, 2009
W-2 Managing Employee
VP of Information and Practice M		 Sep 14, 2009 100%
Corporate Officer
VP of Info & Practice Management		 Sep 14, 2009 100%
W-2 Managing Employee
VP of Info & Practice Management		 Sep 14, 2009 100%
Corporate Officer
VP of Information and Practice M		 Sep 14, 2009 100%
Corporate Officer
VP of Information/Practice Mgmnt		 Sep 14, 2009 100%
W-2 Managing Employee
VP of Information/ Practice Mgmnt		 Sep 14, 2009 100%
Corporate Officer
VP of Information and Practice MGMT		 Sep 14, 2009 100%
W-2 Managing Employee
VP of Information and Practice MGMT		 Sep 14, 2009 100%
Corporate Director
VP of Information/Practice MGMT		 Sep 14, 2009
Corporate Officer
Authorized Official		 Jan 1, 2013
W-2 Managing Employee
VP Info/Practice Management Systems		 Jun 1, 2003
W-2 Managing Employee
VP of Information/Practice MGMT		 Jun 1, 2003
Corporate Officer
VP of Information/Practice MGMT		 Aug 29, 2005
W-2 Managing Employee
VP of Information/Practice MGMT		 Aug 29, 2005
Charlene P Butterfield
Individual 		Corporate Director
Board Member		 Jan 1, 2024
Corporate Officer
Board Member		 May 15, 2025
Corporate Officer
Board Member		 Jan 1, 2024
Robert Scott Heatley
Individual 		Corporate Officer
Board Member		 Jan 1, 2012 100%
Corporate Director
Board Member		 Jan 1, 2012
Corporate Officer Jan 1, 2012
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member		 Jan 1, 2023
Corporate Officer
Board Member		 Jan 1, 2012
Corporate Director
Board Member		 Jan 1, 2007
Sandra Cuellar Oxford
Individual 		Corporate Director
Board Member		 Jan 1, 2004
Corporate Officer
Board Member		 Jan 1, 2004 100%
Corporate Director
Board Member		 Oct 5, 2007
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member		 Jan 1, 2024
Corporate Officer
Board Member		 Jan 1, 2004
Anne K Nolon
Individual 		Corporate Officer
Chief Executive Officer		 Jan 1, 1991 100%
W-2 Managing Employee
Chief Executive Officer		 Jan 1, 1981 100%
Corporate Officer Jan 1, 1991
W-2 Managing Employee Jan 1, 1991
Corporate Officer
Ceo		 Jan 19, 1991 100%
W-2 Managing Employee
Ceo		 Jan 19, 1991 100%
W-2 Managing Employee
Chief Executice Officer		 Jan 1, 1991 100%
Corporate Officer
Ceo		 Jan 1, 1991
Corporate Officer
Chief Executive Officer		 Mar 1, 2022 100%
W-2 Managing Employee
Chief Executive Officer		 Jan 1, 1991 100%
Corporate Officer
Chief Executive Officer		 Jan 19, 1991 100%
W-2 Managing Employee
Chief Executive Officer		 Jan 19, 1991 100%
Corporate Officer
Ceo		 Jan 1, 1991 100%
W-2 Managing Employee
Ceo		 Jan 1, 1991 100%
Corporate Officer
Chief Executive Officer		 Jan 1, 1991
W-2 Managing Employee
Chief Executive Officer		 Jan 1, 1991
Ramona Ceballos
Individual 		Corporate Director
Board Member		 Jan 1, 2008
Corporate Officer Jan 1, 2008
Corporate Officer
Board Member		 Jan 1, 2008 100%
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Director
Board Member		 Jan 1, 2023
Corporate Director
Board Member		 Jan 8, 2008
Kendrick Harris
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Corporate Director
Board Member		 Mar 1, 2022 100%
Corporate Officer
Board Member		 Jan 1, 2019 100%
Norma J Pereira
Individual 		Corporate Director
Board Member		 Jan 1, 2007
Corporate Officer Jan 1, 2007
Corporate Officer
Board Member		 Jan 1, 2007 100%
Corporate Director
Board Member		 Mar 1, 2007
Dolores Guardado
Individual 		Corporate Officer Jan 1, 2013
Corporate Officer
Board Member		 Jan 1, 2013 100%
Corporate Director
Board Member		 Jan 1, 2013
F. Bryan Paz
Individual 		Corporate Officer Jan 1, 1999
Corporate Officer
Board Member		 Jan 1, 1999 100%
Corporate Director Aug 21, 2007
Corporate Director
Board Member		 Jan 1, 1999
Corporate Director
Board Member		 Jan 1, 1999 100%
Elizabeth D Celaya
Individual 		Corporate Officer Jan 1, 2004
Corporate Officer
Board Member		 Jan 1, 2004 100%
Rose Gabriel-Leandre
Individual 		Corporate Officer
Board Member		 Jan 1, 2012 100%
Pedro Nel Masmela
Individual 		Corporate Officer
Board Member		 Jan 1, 2012 100%
Attie Tucker
Individual 		Corporate Officer
Board Member		 Jan 1, 1994 100%
Mara Ruv Al Caba
Individual 		Corporate Officer
Board Member		 Jan 1, 2019
Corporate Officer
Board Member		 Jan 1, 2020
Corporate Director
Board Member		 Jan 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20020829000010 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Poughkeepsie, NY
O20031201000302 CT Part B Supplier - Clinic/Group Practice 6608783568 Receives reassigned benefits from 3 practitioners
Practice locations: Sharon, CT
O20040714000375 NY Part B Supplier - Clinic/Group Practice 6608783568 Receives reassigned benefits from 717 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Paltz, NY; Nyack, NY; Patchogue, NY; Peekskill, NY; Pine Plains, NY; Poughkeepsie, NY; Riverhead, NY; Shirley, NY…
O20070713000414 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Peekskill, NY
O20070822000079 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Goshen, NY
O20070822000304 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Beacon, NY
O20070822000371 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Poughkeepsie, NY
O20070822000409 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Dover Plains, NY
O20070822000821 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Amenia, NY
O20070822000846 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Walden, NY
O20071023000814 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Greenport, NY
O20071023000815 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Haverstraw, NY
O20071023000817 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: New Paltz, NY
O20071023000819 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Monticello, NY
O20090129000506 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Yonkers, NY
O20090130000316 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Yonkers, NY
O20120522000805 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Spring Valley, NY
O20120607000702 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Coram, NY
O20140415000505 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Southampton, NY
O20140610001314 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Hudson, NY
O20140920000089 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Amityville, NY
O20141011000033 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Wyandanch, NY
O20141216000285 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Patchogue, NY
O20150121001429 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Shirley, NY
O20150831002240 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Brentwood, NY
O20151119001596 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Riverhead, NY
O20160804001012 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Nyack, NY
O20161013000680 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 1 other NPI on this enrollment
Practice locations: Middletown, NY
O20180913000005 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Jamaica, NY
O20180913000807 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Bronx, NY
O20180913001376 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Bronx, NY
O20180913001868 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Brooklyn, NY
O20180914000397 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Staten Island, NY
O20180914000814 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Brooklyn, NY
O20180914001340 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: New York, NY
O20180917000144 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Bronx, NY
O20180917000353 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Staten Island, NY
O20180918000018 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Brooklyn, NY
O20190415002623 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Huntington, NY
O20221223000168 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Richmond Hill, NY
O20221223000537 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Bronx, NY
O20221223000664 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Bronx, NY
O20231005002775 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Copiague, NY
O20240909000033 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: White Plains, NY
O20240911000257 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: New Rochelle, NY
O20250520000974 NY Part a Provider - Federally Qualified Health Center (FQHC) 6608783568 Practice locations: Brooklyn, NY

National Provider Directory

Part of
John T Raffalli

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

459 E 149th St
Ste 202
Bronx, NY 10455

459 E 149th St
Bronx, NY 10455
Phone (212) 381-8350

2412 Church Ave
Brooklyn, NY 11226
Phone (347) 404-5950

1669 Bedford Ave
Brooklyn, NY 11225
Phone (718) 467-7200

445 Oak St
Ste 201
Copiague, NY 11726

3174 Route 22
Dover Plains, NY 12522
Phone (845) 877-4793

888 Pulaski Hwy
Goshen, NY 10924
Phone (845) 378-1160

327 Front St
Greenport, NY 11944
Phone (631) 477-2678

26 New Main St
Haverstraw, NY 10927
Phone (845) 429-4499

31 W Broad St
Fl 3
Haverstraw, NY 10927
Phone (845) 429-4499

31 W Broad St
#37
Haverstraw, NY 10927

750 Union St
Hudson, NY 12534
Phone (518) 751-3060

1240 Ulster Ave
Ste 1004
Kingston, NY 12401
Phone (845) 768-1990

23 Lakewood Ave
Monticello, NY 12701
Phone (845) 794-2010

1 Paradies Ln
New Paltz, NY 12561
Phone (845) 255-1760

14 Lawton St
#1
New Rochelle, NY 10801
Phone (855) 844-1975

19 Pilch Dr
Pine Plains, NY 12567
Phone (518) 721-2071

550 Montauk Hwy
Shirley, NY 11967
Phone (631) 852-1000

360 Mamaroneck Ave
#1
White Plains, NY 10605

1556 Straight Path
Wyandanch, NY 11798
Phone (516) 214-8020

1 Hudson St
Yonkers, NY 10701
Phone (914) 963-2626

503 S Broadway
Yonkers, NY 10705
Phone (914) 965-9771

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community Health Clinic/Center 261QC1500X
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X Yes

Addresses

Primary practice location

1037 Main St
Hudson River Healthcare, Inc.
Peekskill, NY 10566-2913

Mailing address

PO Box 5036
White Plains, NY 10602-5036
Phone (914) 734-8800

Other identifiers

IdentifierTypeStateIssuer
003111119MedicaidCT
00473038MedicaidNY

Other providers in Peekskill, NY

All providers in Peekskill, NY · Federally Qualified Health Center (FQHC) in New York

Sources for this page

Verify at the official NPI Registry.