Healthcare Provider Details

I. General information

NPI: 1639418858
Provider Name (Legal Business Name): HUDSON SPINE AND PAIN MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
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 Code261QP3300X
TaxonomyPain Clinic/Center
License Number241732
License Number StateNY

VIII. Authorized Official

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