Healthcare Provider Details

I. General information

NPI: 1518242973
Provider Name (Legal Business Name): HUDSON AMBULATORY MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2011
Last Update Date: 11/14/2017
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

Practice location:
  • Phone: 646-596-7386
  • Fax: 646-360-2739
Mailing address:
  • Phone: 646-596-7386
  • Fax: 646-360-2739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHANN C KUO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 646-596-7386