Provider Demographics
NPI:1366701278
Name:HUDKA, GOPI (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:GOPI
Middle Name:
Last Name:HUDKA
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 UNION ST
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-1857
Mailing Address - Country:US
Mailing Address - Phone:508-425-7000
Mailing Address - Fax:
Practice Address - Street 1:2707 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4823
Practice Address - Country:US
Practice Address - Phone:908-258-7002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233721183500000X
NJ28RI03477400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist