Provider Demographics
NPI:1215905906
Name:BUDD, HENRY
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:BUDD
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 1:205 BROWERTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEST PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2671
Mailing Address - Country:US
Mailing Address - Phone:973-890-9168
Mailing Address - Fax:973-890-9621
Practice Address - Street 1:205 BROWERTOWN RD
Practice Address - Street 2:
Practice Address - City:WEST PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07424-2671
Practice Address - Country:US
Practice Address - Phone:973-890-9168
Practice Address - Fax:973-890-9621
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02597300208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53163Medicare UPIN
NJLO3091263Medicare ID - Type Unspecified