Healthcare Provider Details

I. General information

NPI: 1174844369
Provider Name (Legal Business Name): HUDSON PRIMARY CARE MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2010
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3429 83RD ST
JACKSON HEIGHTS NY
11372-3054
US

IV. Provider business mailing address

3429 83RD ST
JACKSON HEIGHTS NY
11372-3054
US

V. Phone/Fax

Practice location:
  • Phone: 718-424-7800
  • Fax: 718-682-6761
Mailing address:
  • Phone: 718-424-7800
  • Fax: 718-682-6761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number229966
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number229966
License Number StateNY

VIII. Authorized Official

Name: MRS. NIDHI DUGAR
Title or Position: PRESIDENT
Credential: MD
Phone: 718-424-7800