Healthcare Provider Details

I. General information

NPI: 1568707172
Provider Name (Legal Business Name): HUDSON MILESTONES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365-381 CLENDENNY AVE
JERSEY CITY NJ
07304-1168
US

IV. Provider business mailing address

365-381 CLENDENNY AVE
JERSEY CITY NJ
07304-1168
US

V. Phone/Fax

Practice location:
  • Phone: 201-434-7783
  • Fax: 201-434-1860
Mailing address:
  • Phone: 201-434-7783
  • Fax: 201-434-1860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBORAH LYNN LORENZETTI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSW
Phone: 201-434-7783