| Healthalliance Hospital Marys Avenue Campus | |
|
105 Marys Ave Kingston NY 12401-5848 | |
| (845) 943-6007 | |
| (845) 943-6038 |
| Full Name | Healthalliance Hospital Marys Avenue Campus |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 105 Marys Ave, Kingston, New York |
| Authorized Official Name and Position | Mario Difiglia (VICE PRESIDENT) |
| Authorized Official Contact | 9144937909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthalliance Hospital Marys Avenue Campus 105 Marys Ave Kingston NY 12401-5829 Ph: (845) 943-6007 | Healthalliance Hospital Marys Avenue Campus 105 Marys Ave Kingston NY 12401-5848 Ph: (845) 943-6007 |
| NPI Number | 1285601237 |
|---|---|
| Provider Enumeration Date | 03/08/2006 |
| Last Update Date | 03/27/2025 |
| Certification Date | 03/27/2025 |
| Medicare PECOS PAC ID | 5597665844 |
|---|---|
| Medicare Enrollment ID | O20241126001511 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285601237 | NPI | - | NPPES |
| 3185 | Other | NY | GHI PROVIDER ID |
| 6450795 | Other | NY | AETNA PROV ID |
| 000702 | Other | NY | BLUE CROSS PROVIDER NUMBE |
| 00274020 | Medicaid | NY | |
| 103185 | Other | NY | WELLCARE PROV ID |
| 143278 | Other | NY | VALUE OPTIONS PROV ID |
| 10005742 | Other | NY | CDPHP PROVIDER ID |
| UV5282 | Other | NY | MVP HEALTH PLAN PROV ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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