Provider Demographics
NPI:1134684970
Name:HUDSON ORTHO GROUP
Entity Type:Organization
Organization Name:HUDSON ORTHO GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:AZZOLINI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-308-6622
Mailing Address - Street 1:1320 ADAMS ST STE E
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2370
Mailing Address - Country:US
Mailing Address - Phone:201-308-6622
Mailing Address - Fax:201-308-6623
Practice Address - Street 1:1320 ADAMS ST STE E
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-2370
Practice Address - Country:US
Practice Address - Phone:201-308-6622
Practice Address - Fax:201-308-6623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Multi-Specialty
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty