Healthcare Provider Details

I. General information

NPI: 1184656829
Provider Name (Legal Business Name): HUDSON RIVER RADIOLOGY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120-152 48TH STREET
UNION CITY NJ
07087
US

IV. Provider business mailing address

PO BOX 1814
ENGLEWOOD CLIFFS NJ
07632
US

V. Phone/Fax

Practice location:
  • Phone: 201-330-1606
  • Fax: 201-330-7622
Mailing address:
  • Phone: 201-656-5050
  • Fax: 800-706-0381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number23951
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number23951
License Number StateNJ

VIII. Authorized Official

Name: MR. FERAS JALOUDI
Title or Position: PRESIDENT
Credential:
Phone: 201-656-5050