Provider Demographics
NPI:1710350798
Name:HUDSON RIVER RADIOLOGY CENTER LLC
Entity Type:Organization
Organization Name:HUDSON RIVER RADIOLOGY CENTER LLC
Other - Org Name:AMERICAN IMAGING OF UNION CITY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAWAB
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZUBERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-758-8035
Mailing Address - Street 1:120 48TH ST # 152
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-6439
Mailing Address - Country:US
Mailing Address - Phone:201-758-8035
Mailing Address - Fax:
Practice Address - Street 1:120 48TH ST # 152
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-6439
Practice Address - Country:US
Practice Address - Phone:201-758-8035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23951261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0071561Medicaid
094715Medicare PIN