Provider Demographics
NPI:1790387371
Name:HUDSON SPINE INSTITUTE
Entity Type:Organization
Organization Name:HUDSON SPINE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:LESLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-838-1900
Mailing Address - Street 1:8901 KENNEDY BLVD STE 3W
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5392
Mailing Address - Country:US
Mailing Address - Phone:201-907-4727
Mailing Address - Fax:201-907-4737
Practice Address - Street 1:8901 KENNEDY BLVD STE 3W
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5392
Practice Address - Country:US
Practice Address - Phone:201-907-4727
Practice Address - Fax:201-907-4737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty