Provider Demographics
NPI:1457304230
Name:ADVANCED RADIATION ONCOLOGY SERVICES OF HUDSON COUNTY, PC
Entity Type:Organization
Organization Name:ADVANCED RADIATION ONCOLOGY SERVICES OF HUDSON COUNTY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GOPAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-684-1633
Mailing Address - Street 1:1 LETHBRIDGE PLZ
Mailing Address - Street 2:SUITE #20 ROUTE 17 NORTH
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-2126
Mailing Address - Country:US
Mailing Address - Phone:201-684-1616
Mailing Address - Fax:201-684-1661
Practice Address - Street 1:29 E 29TH ST
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4654
Practice Address - Country:US
Practice Address - Phone:201-858-5336
Practice Address - Fax:201-858-7329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8722501Medicaid
NJ8722501Medicaid