Provider Demographics
NPI:1568697779
Name:HUDSON ONCOLOGY HEMATOLOGY
Entity Type:Organization
Organization Name:HUDSON ONCOLOGY HEMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HITENDRAKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-222-2427
Mailing Address - Street 1:7 F X DOWNEY CT
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-2338
Mailing Address - Country:US
Mailing Address - Phone:862-222-2427
Mailing Address - Fax:201-915-2219
Practice Address - Street 1:282 SAINT PAULS AVE
Practice Address - Street 2:GROUND FLOOR MEDICAL OFFICE
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5012
Practice Address - Country:US
Practice Address - Phone:862-222-2424
Practice Address - Fax:201-915-2219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05772000207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7003404Medicaid