Provider Demographics
NPI:1811914773
Name:HUDECHECK, RENEE (OD)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:
Last Name:HUDECHECK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 QUAKER BRIDGE RD
Mailing Address - Street 2:STE 10
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619
Mailing Address - Country:US
Mailing Address - Phone:609-584-9090
Mailing Address - Fax:609-584-7687
Practice Address - Street 1:3800 QUAKER BRIDGE RD
Practice Address - Street 2:STE 10
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619
Practice Address - Country:US
Practice Address - Phone:609-584-9090
Practice Address - Fax:609-584-7687
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270R00462700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4539250001OtherDMERC
NJ4539250001OtherDMERC
NJ412345Medicare ID - Type Unspecified