Healthcare Provider Details

I. General information

NPI: 1477887446
Provider Name (Legal Business Name): PROGRESSIVE HUDSON ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 MARKET ST
SADDLE BROOK NJ
07663-5996
US

IV. Provider business mailing address

PO BOX 1658
HOBOKEN NJ
07030-1658
US

V. Phone/Fax

Practice location:
  • Phone: 201-945-2481
  • Fax: 201-943-8105
Mailing address:
  • Phone: 201-945-2481
  • Fax: 201-943-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SEN-PIN KAO
Title or Position: PRESIDENT
Credential: MD
Phone: 201-945-2481