Provider Demographics
NPI:1093937575
Name:HUDAK, JOSEPH WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:HUDAK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2845
Mailing Address - Country:US
Mailing Address - Phone:732-661-0800
Mailing Address - Fax:732-661-1845
Practice Address - Street 1:909 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2845
Practice Address - Country:US
Practice Address - Phone:732-661-0800
Practice Address - Fax:732-661-1845
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00493900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ893699Medicare PIN