1568697779 NPI number — HUDSON ONCOLOGY HEMATOLOGY

Table of content: (NPI 1568697779)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568697779 NPI number — HUDSON ONCOLOGY HEMATOLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON ONCOLOGY HEMATOLOGY
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:
1568697779
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 F X DOWNEY CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARSIPPANY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07054-2338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
862-222-2427
Provider Business Mailing Address Fax Number:
201-915-2219

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
282 SAINT PAULS AVE
Provider Second Line Business Practice Location Address:
GROUND FLOOR MEDICAL OFFICE
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07306-5012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
862-222-2424
Provider Business Practice Location Address Fax Number:
201-915-2219
Provider Enumeration Date:
05/18/2009

Additional Information

Authorized Official

Authorized Official Last Name:
UPADHYAYA
Authorized Official First Name:
HITENDRAKUMAR
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
862-222-2427

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  25MA05772000 , 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)

  • Identifier: 7003404 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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