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NPI Code Detail

MEDICARE: DR. RENEE HUDECHECK OD

MEDICARE:  DR. RENEE  HUDECHECK  OD
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
1152W00000XOptometrist270R00462700NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14539250001OTHERNJDMERC

General Provider Information

NPI Number : 1811914773
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RENEE HUDECHECK OD
Provider Business Mailing Address
First Line : 3800 QUAKER BRIDGE RD
Second Line : STE 10
City : HAMILTON
State : NJ
Zip : 08619
Country : US
Telephone Number : 609-584-9090
Fax Number : 609-584-7687
Provider Business Practice Location Address
First Line : 3800 QUAKER BRIDGE RD
Second Line : STE 10
City : HAMILTON
State : NJ
Zip : 08619
Country : US
Telephone Number : 609-584-9090
Fax Number : 609-584-7687
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 09/26/2008

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