Provider Demographics
NPI:1689653321
Name:HSU, DAPHNE T (MD)
Entity Type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:T
Last Name:HSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3415 BAINBRIDGE AVE
Mailing Address - Street 2:CHILDREN'S HOSPITAL AT MONTEFIORE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2403
Mailing Address - Country:US
Mailing Address - Phone:718-741-2343
Mailing Address - Fax:
Practice Address - Street 1:3415 BAINBRIDGE AVE
Practice Address - Street 2:CHILDREN'S HOSPITAL AT MONTEFIORE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2403
Practice Address - Country:US
Practice Address - Phone:718-741-2343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1569362080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01085749Medicaid
NY33E751Medicare ID - Type Unspecified
NY01085749Medicaid