MEDICARE: HUDSON PRIMARY CARE MEDICAL PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	229966	NY
2	207R00000X	Internal Medicine Physician	229966	NY

General Provider Information

NPI Number	:	1174844369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON PRIMARY CARE MEDICAL PC

Provider Business Mailing Address
First Line	:	3429 83RD ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3054
Country	:	US
Telephone Number	:	718-424-7800
Fax Number	:	718-424-0888

Provider Business Practice Location Address
First Line	:	3429 83RD ST
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-3054
Country	:	US
Telephone Number	:	718-424-7800
Fax Number	:	718-424-0888

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. NIDHI DUGAR
Credential	:	M.D.
Telephone Number	:	718-424-7800

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	06/29/2021

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Directions to “HUDSON PRIMARY CARE MEDICAL PC ” Practice Location

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