Basic Information
| Provider Information | |||||||||
| NPI: | 1043252414 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUDSON EYE PHYSICIANS & SURGEONS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 PAVONIA AVE | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073062929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019633937 | ||||||||
| FaxNumber: | 2019638823 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 PAVONIA AVE | ||||||||
| Address2: | 6TH FLOOR | ||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073062929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019633937 | ||||||||
| FaxNumber: | 2019638823 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 12/09/2014 | ||||||||
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| AuthorizedOfficialLastName: | CONSTAD | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 2019633937 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.