Basic Information
| Provider Information | |||||||||
| NPI: | 1568697779 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUDSON ONCOLOGY HEMATOLOGY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 F X DOWNEY CT | ||||||||
| Address2: | |||||||||
| City: | PARSIPPANY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070542338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8622222427 | ||||||||
| FaxNumber: | 2019152219 | ||||||||
| Practice Location | |||||||||
| Address1: | 282 SAINT PAULS AVE | ||||||||
| Address2: | GROUND FLOOR MEDICAL OFFICE | ||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073065012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8622222424 | ||||||||
| FaxNumber: | 2019152219 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2009 | ||||||||
| LastUpdateDate: | 05/18/2009 | ||||||||
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| AuthorizedOfficialLastName: | UPADHYAYA | ||||||||
| AuthorizedOfficialFirstName: | HITENDRAKUMAR | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8622222427 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | 25MA05772000 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 7003404 | 05 | NJ | MEDICAID |