Provider Demographics
NPI:1841273166
Name:HUDZINSKI, LORI D (MD)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:D
Last Name:HUDZINSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14141-1442
Mailing Address - Country:US
Mailing Address - Phone:716-592-3602
Mailing Address - Fax:716-592-2929
Practice Address - Street 1:210 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:14141-1442
Practice Address - Country:US
Practice Address - Phone:716-592-3635
Practice Address - Fax:716-592-2929
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000510001003OtherBCBS
NY00020003101OtherUNIVERA
NY0003153OtherGHI
NY00955615Medicaid
NY0103647AOAOtherINDEPENDENT HEALTH
NY0145550001OtherDMERC
NY166116-1OtherWORKERS COMP
NY0103647AOAOtherINDEPENDENT HEALTH
NYQ48231Medicare PIN