Healthcare Provider Details

I. General information

NPI: 1841273166
Provider Name (Legal Business Name): LORI D HUDZINSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E MAIN ST
SPRINGVILLE NY
14141-1442
US

IV. Provider business mailing address

210 E MAIN ST
SPRINGVILLE NY
14141-1442
US

V. Phone/Fax

Practice location:
  • Phone: 716-592-3635
  • Fax: 716-592-2929
Mailing address:
  • Phone: 716-592-3602
  • Fax: 716-592-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number166116
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: