Provider Demographics
NPI:1194722868
Name:PUTNAM VALLEY PEDIATRICS, P.C.
Entity type:Organization
Organization Name:PUTNAM VALLEY PEDIATRICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MILLAR
Authorized Official - Last Name:ZURHELLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-528-5222
Mailing Address - Street 1:4 MORRISSEY DR
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-3018
Mailing Address - Country:US
Mailing Address - Phone:845-528-5222
Mailing Address - Fax:845-528-8589
Practice Address - Street 1:4 MORRISSEY DR
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-3018
Practice Address - Country:US
Practice Address - Phone:845-528-5222
Practice Address - Fax:845-528-8589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118059208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty