Provider Demographics
NPI:1124072715
Name:NORTHERN DUTCHESS HOSPITAL
Entity type:Organization
Organization Name:NORTHERN DUTCHESS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-739-7240
Mailing Address - Street 1:6511 SPRING BROOK AVE
Mailing Address - Street 2:POBOX5002
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-3709
Mailing Address - Country:US
Mailing Address - Phone:845-876-3001
Mailing Address - Fax:845-838-8062
Practice Address - Street 1:6511 SPRING BROOK AVE
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-3709
Practice Address - Country:US
Practice Address - Phone:845-876-3001
Practice Address - Fax:845-838-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1327000H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00268300Medicaid
0300OtherMVP
HO1504OtherOXFORD
103199OtherWELLCARE
10017288OtherCDPHP
000357OtherBLUE CROSS
3199OtherGHI HMO
3199OtherGHI HMO
10017288OtherCDPHP
=========OtherHEALTHNET
NY330049Medicare Oscar/Certification