Provider Demographics
NPI:1952005373
Name:HUDSON PRO ORTHOPAEDICS AND SPORTS MEDICINE
Entity Type:Organization
Organization Name:HUDSON PRO ORTHOPAEDICS AND SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IMRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHRAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-308-6623
Mailing Address - Street 1:571 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2424
Mailing Address - Country:US
Mailing Address - Phone:201-308-6622
Mailing Address - Fax:
Practice Address - Street 1:571 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2424
Practice Address - Country:US
Practice Address - Phone:201-308-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty