Healthcare Provider Details
I. General information
NPI: 1710265509
Provider Name (Legal Business Name): HUDSON ANESTHESIA SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2011
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
281 BROADWAY 2ND FLOOR
NEW YORK NY
10007-1831
US
IV. Provider business mailing address
281 BROADWAY 2ND FLOOR
NEW YORK NY
10007-1831
US
V. Phone/Fax
- Phone: 646-596-7386
- Fax: 646-360-2739
- Phone: 646-596-7386
- Fax: 646-360-2739
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | 241732 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
JONATHANN
C.
KUO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 646-596-7386