Provider Demographics
NPI:1174844369
Name:HUDSON PRIMARY CARE MEDICAL PC
Entity Type:Organization
Organization Name:HUDSON PRIMARY CARE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIDHI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-424-7800
Mailing Address - Street 1:3429 83RD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3054
Mailing Address - Country:US
Mailing Address - Phone:718-424-7800
Mailing Address - Fax:718-424-0888
Practice Address - Street 1:3429 83RD ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-3054
Practice Address - Country:US
Practice Address - Phone:718-424-7800
Practice Address - Fax:718-424-0888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229966207R00000X, 207RG0300X
NY238516207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty