Healthcare Provider Details

I. General information

NPI: 1528150729
Provider Name (Legal Business Name): PENELOPE HSU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WALKER ST FL 2
NEW YORK NY
10013-4135
US

IV. Provider business mailing address

125 WALKER ST FL 2
NEW YORK NY
10013-4135
US

V. Phone/Fax

Practice location:
  • Phone: 212-226-3888
  • Fax: 212-334-6887
Mailing address:
  • Phone: 212-226-3888
  • Fax: 212-334-6887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberA88553
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number222521
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: