Provider Demographics
NPI:1396774246
Name:HUDSON MRI PA
Entity type:Organization
Organization Name:HUDSON MRI PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER /CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:FETOUH
Authorized Official - Last Name:EL SAYED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-647-3319
Mailing Address - Street 1:2811 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2227
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2811 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-2227
Practice Address - Country:US
Practice Address - Phone:201-659-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0200X
NJ80320261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013442OtherHORIZAN NJ HEALTH
HU000002600OtherAMERICHOICE
470001913OtherPALMETTO GBA
0008618OtherGHI
A678164OtherOXFORD
XK5488OtherHEALTHNET OF NE
NJ2N109OtherMEDICARE
0788531000OtherAMERIHEALTH HMO
NJ2N1092OtherMEDICARE
NJ3327400Medicaid
43021OtherAETNA
21940OtherUNIVERSITY HEALTH PLAN
W4R521OtherWELLCHOICE