Provider Demographics
NPI:1275524035
Name:HUDSON, HOWARD P (DPM)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:P
Last Name:HUDSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 ROUTE 70
Mailing Address - Street 2:SUITE 21 S
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5900
Mailing Address - Country:US
Mailing Address - Phone:732-367-2220
Mailing Address - Fax:732-367-2293
Practice Address - Street 1:1255 ROUTE 70
Practice Address - Street 2:SUITE 21 S
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5900
Practice Address - Country:US
Practice Address - Phone:732-367-2220
Practice Address - Fax:732-367-2293
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMD000958213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT78469Medicare UPIN
NJHU124428Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER