Healthcare Provider Details

I. General information

NPI: 1376738765
Provider Name (Legal Business Name): HUDSON DIGESTIVE HEALTH CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 AVENUE E SUITE 1-A
BAYONNE NJ
07002-3987
US

IV. Provider business mailing address

534 AVENUE E SUITE 1-A
BAYONNE NJ
07002-3987
US

V. Phone/Fax

Practice location:
  • Phone: 201-858-8444
  • Fax: 201-858-4260
Mailing address:
  • Phone: 201-858-8444
  • Fax: 201-858-4260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANAKA PRAKASH
Title or Position: DIRECTOR
Credential: MD
Phone: 201-858-8444