Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Rondout Valley Family Med PC

Organization Family Medicine Physician · NPI 1679514004

Rondout Valley Family Med PC provides Family Medicine Physician services in Stone Ridge, New York. Licensed in New York. Registered with an NPI since 2006.

Licensed in
NY
In the registry since
2006
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10 Gagnon Dr
Stone Ridge, NY 12484-5120 Not confirmed with CMS for 18 years — call before visiting
Phone: (845) 687-9933
Fax: (845) 687-9953
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 160527 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 008467-1 (NY)

Record details

NPI number1679514004
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Peter Petrulis — President · (845) 687-9933
NPI enumeratedJune 9, 2006
Last updated in NPPESOctober 9, 2007
Mailing addressPo Box 547, Stone Ridge, NY 12484-0547

Other providers in Stone Ridge