Provider Demographics
NPI:1740312453
Name:HUDSON MEDICAL PRACTICE PC
Entity type:Organization
Organization Name:HUDSON MEDICAL PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASHMAT
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAJPUT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-479-2335
Mailing Address - Street 1:1 BEACH ROAD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-3201
Mailing Address - Country:US
Mailing Address - Phone:914-736-2616
Mailing Address - Fax:914-941-4421
Practice Address - Street 1:2042 ALBANY POST ROAD
Practice Address - Street 2:SUITE #3
Practice Address - City:CROTON
Practice Address - State:NY
Practice Address - Zip Code:10520-1128
Practice Address - Country:US
Practice Address - Phone:914-736-2616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
15E302Medicare ID - Type Unspecified
WEF211Medicare PIN