Healthcare Provider Details

I. General information

NPI: 1225119647
Provider Name (Legal Business Name): GOLDA HUDES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MONTEFIORE MEDICAL PARK 1515 BLONDELL AVENUE, STE. 220
BRONX NY
10461
US

IV. Provider business mailing address

310 W 72ND ST APT. 2D
NEW YORK NY
10023-2675
US

V. Phone/Fax

Practice location:
  • Phone: 866-633-8255
  • Fax:
Mailing address:
  • Phone: 866-633-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number204068
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: