Individual
DEREK HUDSON SUITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1136 NEILL AVE, BRONX, NY 10461-1328
(718) 518-7600
(718) 518-7647
Mailing address
1136 NEILL AVENUE, BRONX, NY 10461-2801
(718) 518-7600
(718) 518-7647
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
198909-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02501820
—
NY
Enumeration date
11/11/2005
Last updated
05/27/2015
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