Provider Demographics
NPI:1215293048
Name:HUDSON VALLEY OPHTHALMOLOGY PLLC
Entity type:Organization
Organization Name:HUDSON VALLEY OPHTHALMOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:ULLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-828-3391
Mailing Address - Street 1:820 UNION ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:91 MONTGOMERY ST # 93
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1122
Practice Address - Country:US
Practice Address - Phone:845-876-3391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01787306Medicaid
NY082X1110OtherMEDICARE
NYG58181Medicare UPIN
NYB20676Medicare UPIN
NY01787306Medicaid