MEDICARE: DR. TIMOTHY HSU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	219460	NY
2	2084P0800X	Psychiatry Physician	42857	MI
3	2084P0800X	Psychiatry Physician	0101257008	VA

General Provider Information

NPI Number	:	1427356310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY HSU M.D.

Provider Business Mailing Address
First Line	:	3447 86TH ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3350
Country	:	US
Telephone Number	:	718-476-0727
Fax Number	:	718-476-0727

Provider Business Practice Location Address
First Line	:	3447 86TH ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3350
Country	:	US
Telephone Number	:	718-476-0727
Fax Number	:	718-476-0727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2011
Last Update Date	:	05/14/2015

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