Basic Information
| Provider Information | |||||||||
| NPI: | 1396738845 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HECHANOVA | ||||||||
| FirstName: | ARNEL | ||||||||
| MiddleName: | B. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 813 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125343007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188284125 | ||||||||
| FaxNumber: | 5186975324 | ||||||||
| Practice Location | |||||||||
| Address1: | 813 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125343007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5188284125 | ||||||||
| FaxNumber: | 5186975324 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2005 | ||||||||
| LastUpdateDate: | 04/10/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 225551 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 02290788 | 05 | NY | MEDICAID |