Provider Demographics
NPI:1194880104
Name:ALL ABOUT AESTHETICS PC
Entity type:Organization
Organization Name:ALL ABOUT AESTHETICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:KESSLER
Authorized Official - Last Name:HUDAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-845-0333
Mailing Address - Street 1:PO BOX 99717
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27624-9717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8311 BANDFORD WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2756
Practice Address - Country:US
Practice Address - Phone:919-845-0333
Practice Address - Fax:919-845-0773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC130069261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911904Medicaid
NC2327563Medicare PIN