Provider Demographics
NPI:1407173941
Name:HUDACKO, RACHEL MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARY
Last Name:HUDACKO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:535 E CRESCENT AVE
Mailing Address - Street 2:C/O HISTOPAHTOLOGY SERVICES, LLC
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2922
Mailing Address - Country:US
Mailing Address - Phone:201-661-7280
Mailing Address - Fax:201-661-7297
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:GOOD SAMARITAN HOSPITAL
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-368-5179
Practice Address - Fax:201-661-7297
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2024-04-25
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08816400207ZC0500X, 207ZP0102X
NY254602207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400071611Medicare PIN