Provider Demographics
NPI:1306593033
Name:HUDON VALLEY MEDICAL PC
Entity type:Organization
Organization Name:HUDON VALLEY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:KROSNEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-720-6930
Mailing Address - Street 1:188 LUDLOW ST APT 6B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-1682
Mailing Address - Country:US
Mailing Address - Phone:305-720-6930
Mailing Address - Fax:
Practice Address - Street 1:59 VERONICA AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3579
Practice Address - Country:US
Practice Address - Phone:732-339-3068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty