Provider Demographics
NPI:1891517330
Name:POUGHKEEPSIE FAMILY HEALTH CARE NP PLLC
Entity type:Organization
Organization Name:POUGHKEEPSIE FAMILY HEALTH CARE NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-554-5599
Mailing Address - Street 1:207 WASHINGTON ST STE 201
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-8112
Mailing Address - Country:US
Mailing Address - Phone:845-452-4671
Mailing Address - Fax:877-801-5104
Practice Address - Street 1:207 WASHINGTON ST STE 201
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-8112
Practice Address - Country:US
Practice Address - Phone:845-452-4671
Practice Address - Fax:877-801-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty