1346267150 NPI number — HUDSON COUNTY ORTHODONTICS LLC

Table of content: (NPI 1346267150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346267150 NPI number — HUDSON COUNTY ORTHODONTICS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON COUNTY ORTHODONTICS 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:
1346267150
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:
42 LOCUST LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST RUTHERFORD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07073-1014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-653-4474
Provider Business Mailing Address Fax Number:
201-623-2500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1160 KENNEDY BLVD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BAYONNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07002-3128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-653-4474
Provider Business Practice Location Address Fax Number:
201-623-2500
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MESSANA
Authorized Official First Name:
BERNADETTA
Authorized Official Middle Name:
FRANCISZKA
Authorized Official Title or Position:
GENERAL PARTNER
Authorized Official Telephone Number:
201-653-4474

Provider Taxonomy Codes

  • Taxonomy code: 1223X0400X , with the licence number:  DI018514 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com