| Pine Grove Health Center | |
|
350 Washington Ave Kingston NY 12401-3702 | |
| (845) 339-4733 | |
| Not Available |
| Full Name | Pine Grove Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 350 Washington Ave, Kingston, New York |
| Authorized Official Name and Position | Neil Calman (PRESIDENT AND CEO) |
| Authorized Official Contact | 2122065200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Grove Health Center Cl # 4655 Po Box 95000 Philadelphia PA 19195-4655 Ph: (845) 255-3435 | Pine Grove Health Center 350 Washington Ave Kingston NY 12401-3702 Ph: (845) 339-4733 |
| NPI Number | 1861765935 |
|---|---|
| Provider Enumeration Date | 02/20/2012 |
| Last Update Date | 04/01/2024 |
| Certification Date | 04/01/2024 |
| Medicare PECOS PAC ID | 9234048588 |
|---|---|
| Medicare Enrollment ID | O20140818002680 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861765935 | NPI | - | NPPES |
| 00903700 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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