Provider Demographics
NPI:1104831841
Name:KHUDA, ABUL B (MD)
Entity Type:Individual
Prefix:
First Name:ABUL
Middle Name:B
Last Name:KHUDA
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:396 BROADWAY
Mailing Address - Street 2:MID HUDSON PHYSICIANS, PC
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4626
Mailing Address - Country:US
Mailing Address - Phone:845-331-3131
Mailing Address - Fax:845-334-2898
Practice Address - Street 1:396 BROADWAY
Practice Address - Street 2:MID HUDSON PHYSICIANS, PC
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4626
Practice Address - Country:US
Practice Address - Phone:845-331-3131
Practice Address - Fax:845-334-2898
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2015-07-14
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Provider Licenses
StateLicense IDTaxonomies
NY236708207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02797299Medicaid
NYA400067287Medicare PIN