MEDICARE: HUDSON HEALTH CHIROPRACTIC, PLLC

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	111NN1001X	Nutrition Chiropractor	011486	NY

General Provider Information

NPI Number	:	1942748942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON HEALTH CHIROPRACTIC, PLLC

Provider Business Mailing Address
First Line	:	111 N GRANT AVE
Second Line	:
City	:	CONGERS
State	:	NY
Zip	:	10920-1612
Country	:	US
Telephone Number	:	914-714-8452
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 SMITH ST STE 202
Second Line	:
City	:	NANUET
State	:	NY
Zip	:	10954-2971
Country	:	US
Telephone Number	:	845-623-6333
Fax Number	:	845-623-5333

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	JOSEPH TACCETTA
Credential	:	D.C.
Telephone Number	:	914-714-8452

Provider Enumeration Date	:	02/09/2017
Last Update Date	:	02/09/2017

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