Provider Demographics
NPI:1821147612
Name:HSU, CECILIA (MD)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:
Last Name:HSU
Suffix:
Gender:F
Credentials:MD
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 15084
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66285-5084
Mailing Address - Country:US
Mailing Address - Phone:913-287-8087
Mailing Address - Fax:913-491-6657
Practice Address - Street 1:5701 STATE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-1236
Practice Address - Country:US
Practice Address - Phone:913-287-8087
Practice Address - Fax:913-491-6657
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS20404174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist