Provider Demographics
NPI:1720224207
Name:HUDSON NEUROLOGICS, LLC
Entity Type:Organization
Organization Name:HUDSON NEUROLOGICS, LLC
Other - Org Name:HUDSON NEUROSCIENCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:DOMINICK
Authorized Official - Last Name:ANSELMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-339-6531
Mailing Address - Street 1:1222 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-9211
Mailing Address - Country:US
Mailing Address - Phone:201-339-6531
Mailing Address - Fax:201-339-6536
Practice Address - Street 1:1222 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-9211
Practice Address - Country:US
Practice Address - Phone:201-339-6531
Practice Address - Fax:201-339-6536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty