Individual
DR. BRUCE G. EVENCHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
820 UNION ST., HUDSON, NY 12534
(518) 828-3391
(518) 828-6734
Mailing address
820 UNION ST., HUDSON, NY 12534
(518) 828-3391
(518) 828-6734
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
148821
NY
207W00000X
Ophthalmology Physician
Primary
47753
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0154954
—
MA
01
—
1010050002
GB MEDICARE NSC
MA
Enumeration date
04/11/2006
Last updated
02/25/2022
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