1396774246 NPI number — HUDSON MRI PA

Table of content: (NPI 1396774246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396774246 NPI number — HUDSON MRI PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON MRI PA
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:
HUDSON MRI PA
Provider Other Organization Name Type Code:
4
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:
1396774246
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2811 KENNEDY BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH BERGEN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07047-2227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2811 KENNEDY BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH BERGEN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07047-2227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-659-1177
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EL SAYED
Authorized Official First Name:
ABDUL
Authorized Official Middle Name:
FETOUH
Authorized Official Title or Position:
OWNER /CEO
Authorized Official Telephone Number:
201-647-3319

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  80320 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1013442 . This is a "HORIZAN NJ HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: HU000002600 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 470001913 . This is a "PALMETTO GBA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0008618 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: A678164 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: XK5488 . This is a "HEALTHNET OF NE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2N109 . This is a "MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0788531000 . This is a "AMERIHEALTH HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2N1092 . This is a "MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3327400 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 43021 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21940 . This is a "UNIVERSITY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: W4R521 . This is a "WELLCHOICE" identifier . This identifiers is of the category "OTHER".




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