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40 Hurley Ave. Ste. 4 Kingston NY 12401 845-338-5600 845-338-3058 Fax Section 1 4250 Albany Post Rd Ste. I have the responsibility of full disclosure of medical information to assist in establishing a diagnosis and an appropriate plan of care. 1 Hyde Park NY 12538 845-229-2602 845-229-2830 Fax PATIENT INFORMATION Primary reason for today s visit E-mail Address for health news letter and payment receipt Pharmacy Address Last Name First Middle Street 306 Windsor Highway New Windsor NY 12553...

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