Provider Demographics
NPI:1619573615
Name:HUDSON HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:HUDSON HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-435-4548
Mailing Address - Street 1:701 STATE RT 440 STE 33
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1069
Mailing Address - Country:US
Mailing Address - Phone:201-435-4548
Mailing Address - Fax:
Practice Address - Street 1:701 STATE RT 440 STE 33
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1069
Practice Address - Country:US
Practice Address - Phone:201-435-4548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service