Provider Demographics
NPI:1053128363
Name:HUDSON FAMILY MEDICAL PC
Entity type:Organization
Organization Name:HUDSON FAMILY MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ADEEL
Authorized Official - Middle Name:SHAHID
Authorized Official - Last Name:YOUSPHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-204-8480
Mailing Address - Street 1:226 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5302
Mailing Address - Country:US
Mailing Address - Phone:845-204-8480
Mailing Address - Fax:845-502-9520
Practice Address - Street 1:226 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5302
Practice Address - Country:US
Practice Address - Phone:845-204-8480
Practice Address - Fax:845-502-9520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty