Provider Demographics
NPI:1174650865
Name:HUDSON HEIGHTS SERVICES, INC
Entity Type:Organization
Organization Name:HUDSON HEIGHTS SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRALDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-420-8170
Mailing Address - Street 1:105 AUDUBON AVE
Mailing Address - Street 2:STE W C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2210
Mailing Address - Country:US
Mailing Address - Phone:646-420-8170
Mailing Address - Fax:
Practice Address - Street 1:105 AUDUBON AVE
Practice Address - Street 2:STE W C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-2210
Practice Address - Country:US
Practice Address - Phone:646-420-8170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY094089-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00154590Medicaid
NY00154590Medicaid
NY00154590Medicaid
NY=========OtherTAX ID#