Healthcare Provider Details

I. General information

NPI: 1396774246
Provider Name (Legal Business Name): HUDSON MRI PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 06/13/2023
Certification Date: 06/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 KENNEDY BLVD
NORTH BERGEN NJ
07047-2227
US

IV. Provider business mailing address

2811 KENNEDY BLVD
NORTH BERGEN NJ
07047-2227
US

V. Phone/Fax

Practice location:
  • Phone: 201-659-1177
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number80320
License Number StateNJ

VIII. Authorized Official

Name: ABDUL FETOUH EL SAYED
Title or Position: OWNER /CEO
Credential:
Phone: 201-647-3319