Provider Demographics
NPI:1770554974
Name:HUDSON INFECTIOUS DISEASE ASSOCIATES PC
Entity type:Organization
Organization Name:HUDSON INFECTIOUS DISEASE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-762-2276
Mailing Address - Street 1:302 CHAPPAQUA RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1354
Mailing Address - Country:US
Mailing Address - Phone:914-762-2276
Mailing Address - Fax:914-762-2894
Practice Address - Street 1:302 CHAPPAQUA RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1354
Practice Address - Country:US
Practice Address - Phone:914-762-2276
Practice Address - Fax:914-762-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01634028Medicaid
NYW9L431Medicare ID - Type Unspecified