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General NPI Number Information
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NPI Number | 1366795593
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Entity Type | Organization
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Legal Business Name | HUDSON RICHMOND DERMATOLOGYM.D., P.A.
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Dates
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Enumeration Date | 10/25/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 333 AVENUE C
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City | BAYONNE
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State | NJ
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Zip | 07002-1471
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Country | US
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Telephone | 201-858-4800
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Fax | 201-858-3005
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Provider Business Mailing Address
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Address Line | 333 AVENUE C
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City | BAYONNE
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State | NJ
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Zip | 07002-1471
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Country | US
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Telephone | 201-858-4800
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Fax | 201-858-3005
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Authorized Official
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Title or Position | M.D.
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Name | DR. ELLEN BLANK
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Credential |
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Telephone | 201-858-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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