Healthcare Provider Details

I. General information

NPI: 1770567406
Provider Name (Legal Business Name): KENNETH S HU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 34TH ST DEPT. OF RADIATION ONCOLOGY
NEW YORK NY
10016-4744
US

IV. Provider business mailing address

160 E 34TH ST DEPT. OF RADIATION ONCOLOGY
NEW YORK NY
10016-4744
US

V. Phone/Fax

Practice location:
  • Phone: 212-731-6033
  • Fax: 212-731-5513
Mailing address:
  • Phone: 212-731-6033
  • Fax: 212-731-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number201837
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: