Provider Demographics
NPI:1952606923
Name:HUDSON PRIMARY CARE PROFESSIONALS
Entity Type:Organization
Organization Name:HUDSON PRIMARY CARE PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-743-7090
Mailing Address - Street 1:72 VAN REIPEN AVE
Mailing Address - Street 2:PO BOX 234
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2806
Mailing Address - Country:US
Mailing Address - Phone:718-743-7090
Mailing Address - Fax:
Practice Address - Street 1:709 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2803
Practice Address - Country:US
Practice Address - Phone:718-743-7090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB065822207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty