Provider Demographics
NPI:1396738845
Name:HECHANOVA, ARNEL B (MD)
Entity type:Individual
Prefix:DR
First Name:ARNEL
Middle Name:B
Last Name:HECHANOVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-3007
Mailing Address - Country:US
Mailing Address - Phone:518-828-4125
Mailing Address - Fax:518-697-5324
Practice Address - Street 1:813 WARREN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-3007
Practice Address - Country:US
Practice Address - Phone:518-828-4125
Practice Address - Fax:518-697-5324
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225551208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02290788Medicaid
NY02290788Medicaid