Provider Demographics
NPI:1821239328
Name:HUDSON MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:HUDSON MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-656-0142
Mailing Address - Street 1:PO BOX 503
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-0503
Mailing Address - Country:US
Mailing Address - Phone:917-656-0142
Mailing Address - Fax:
Practice Address - Street 1:175 MEMORIAL HWY STE 2-6
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5640
Practice Address - Country:US
Practice Address - Phone:914-355-4500
Practice Address - Fax:914-355-5397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208757174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02622791Medicaid
NY753D01Medicare PIN
NY02622791Medicaid