Provider Demographics
NPI:1386978930
Name:XHUDO, TONY F (MS, HN, BC)
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:F
Last Name:XHUDO
Suffix:
Gender:M
Credentials:MS, HN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1319
Mailing Address - Country:US
Mailing Address - Phone:845-508-6302
Mailing Address - Fax:845-508-6302
Practice Address - Street 1:84 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORIDA
Practice Address - State:NY
Practice Address - Zip Code:10921-1319
Practice Address - Country:US
Practice Address - Phone:845-508-6302
Practice Address - Fax:845-508-6302
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20090065764173C00000X, 175F00000X, 175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No173C00000XOther Service ProvidersReflexologist
No175L00000XOther Service ProvidersHomeopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY27-0452912OtherEIN