Provider Demographics
NPI:1457490310
Name:ESSEX HUDSON CARDIOLOGY ASSOCIATES, LLP
Entity Type:Organization
Organization Name:ESSEX HUDSON CARDIOLOGY ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NAJAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WASTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-926-8592
Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:G4
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-8592
Mailing Address - Fax:973-923-8859
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:G4
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-8592
Practice Address - Fax:973-923-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04020900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7636300Medicaid
NJ902522Medicare PIN