Provider Demographics
NPI:1376031062
Name:HUDSON PEDIATRIC NEUROLOGY CENTER, LLC
Entity Type:Organization
Organization Name:HUDSON PEDIATRIC NEUROLOGY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAABAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-892-2938
Mailing Address - Street 1:33-41 NEWARK ST STE 4C
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5620
Mailing Address - Country:US
Mailing Address - Phone:201-892-2938
Mailing Address - Fax:201-533-0223
Practice Address - Street 1:33-41 NEWARK ST STE 4C
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5620
Practice Address - Country:US
Practice Address - Phone:201-892-2938
Practice Address - Fax:201-533-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty