1316978414 NPI number — HUDSON ANESTHESIOLOGY SERVICES, LLC

Table of content: MS. AMANDA JUDITH ORTMANN AUD (NPI 1275633422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316978414 NPI number — HUDSON ANESTHESIOLOGY SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON ANESTHESIOLOGY SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316978414
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 51020
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07101-5120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-945-2481
Provider Business Mailing Address Fax Number:
201-943-8105

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 WILLOW AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOBOKEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07030-3808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-945-2481
Provider Business Practice Location Address Fax Number:
201-943-8105
Provider Enumeration Date:
07/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KAO
Authorized Official First Name:
SEN-PIN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
201-945-2481

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8861609 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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