Provider Demographics
NPI:1104451681
Name:HSU, ALBERT
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:HSU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:NORTH LAWRENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44666-0181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2486 MANCHESTER AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH LAWRENCE
Practice Address - State:OH
Practice Address - Zip Code:44666-9446
Practice Address - Country:US
Practice Address - Phone:330-268-8597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-05
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X, 374U00000X
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No374U00000XNursing Service Related ProvidersHome Health Aide