Provider Demographics
NPI:1902425945
Name:HSU, KIMBERLY MEI (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MEI
Last Name:HSU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:MEI
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVENUE
Mailing Address - Street 2:BOX 679
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642
Mailing Address - Country:US
Mailing Address - Phone:585-275-4290
Mailing Address - Fax:585-473-1573
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:#679
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-4290
Practice Address - Fax:585-473-1573
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program