OrganizationActive
Hudson Headwaters Health Network
NPI 1154343168 · Physician Assistant · Indian Lake, NY
Provider details
- NPI number
- 1154343168
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- Hudson Headwaters Health Network
- Organization subpart
- Yes
- Authorized official
- Christopher Tournier, Chief Financial Officer(518) 761-0300
- License
- 6846 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Main Street and Pelon Road
Indian Lake, NY 12842-0684
Phone: (518) 648-5707
Fax: (518) 648-6160
Street-level locationGet directions
Mailing address
9 Carey Rd
Queensbury, NY 12804-7880
Registry dates
- Enumerated
- 2006-07-25
- Last updated
- 2010-09-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.