Healthcare Provider Details

I. General information

NPI: 1750104642
Provider Name (Legal Business Name): HUDSON KIDS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 WEST ST STE 203-1
UNION CITY NJ
07087-4694
US

IV. Provider business mailing address

2000 WEST ST STE 203-1
UNION CITY NJ
07087-4694
US

V. Phone/Fax

Practice location:
  • Phone: 551-300-0229
  • Fax:
Mailing address:
  • Phone: 551-300-0229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MAYK F ALSAQQA
Title or Position: OWNER
Credential: OT
Phone: 551-300-0229