1639286735 NPI number — HUDSON IMAGING PA

Table of content: (NPI 1639286735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639286735 NPI number — HUDSON IMAGING PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUDSON IMAGING 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:
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:
1639286735
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:
75 MONTGOMERY STREET
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
JERSEY CITY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-369-1900
Provider Business Mailing Address Fax Number:
201-369-9300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 MONTGOMERY STREET
Provider Second Line Business Practice Location Address:
SUITE 401
Provider Business Practice Location Address City Name:
JERSEY CITY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-369-1900
Provider Business Practice Location Address Fax Number:
201-369-9300
Provider Enumeration Date:
08/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GREISS
Authorized Official First Name:
KAMAL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
201-369-1900

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  23417 , 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: 101408 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2964536 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7249376 . This is a "AETNA ALL OTHERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8820902 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: W1L831 . This is a "WELLCHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1412491 . This is a "AMERIHEALTH PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2099468000 . This is a "AMERIHEALTH HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8820902 . This is a "UNISYS" identifier . This identifiers is of the category "OTHER".
  • Identifier: A2839370 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 056977 . This is a "RAILROAD MEDICARE PIN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1171229 . This is a "HORIZON NJ HEALTH MERCY" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: HUL00020901 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7249376 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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