Basic Information
Provider Information
NPI: 1922236561
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HSU
FirstName: JANICE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2008 CARIBOU DR
Address2:  
City: FORT COLLINS
State: CO
PostalCode: 805254325
CountryCode: US
TelephoneNumber: 9704844757
FaxNumber: 9704844759
Practice Location
Address1: 1024 S LEMAY AVE
Address2:  
City: FORT COLLINS
State: CO
PostalCode: 805243929
CountryCode: US
TelephoneNumber: 9704958600
FaxNumber: 9704957619
Other Information
ProviderEnumerationDate: 06/22/2009
LastUpdateDate: 07/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X54975COY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202X28451NEN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0202XTL2950WYN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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