Individual
ELIZABETH SUSAN HODGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-4638
(973) 923-6487
Mailing address
201 LYONS AVE, NEWARK, NJ 07112-2027
(973) 926-4638
(973) 923-6487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA06103600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
727642B3L
MEDICARE ID
NJ
05
—
7412606
—
NJ
Enumeration date
07/19/2006
Last updated
03/08/2012
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