Provider Demographics
NPI:1558460576
Name:HUDES, ELIOT S (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIOT
Middle Name:S
Last Name:HUDES
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:PO BOX 2103
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-0203
Mailing Address - Country:US
Mailing Address - Phone:845-462-3400
Mailing Address - Fax:845-462-7590
Practice Address - Street 1:1984 NEW HACKENSACK RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-4351
Practice Address - Country:US
Practice Address - Phone:845-462-3400
Practice Address - Fax:845-462-7590
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX01920111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
T51928Medicare UPIN
X11781Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER