Healthcare Provider Details

I. General information

NPI: 1083549562
Provider Name (Legal Business Name): HUDSON MD SELECT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 NORTHFIELD AVE FL 202
WEST ORANGE NJ
07052-3022
US

IV. Provider business mailing address

443 NORTHFIELD AVE FL 202
WEST ORANGE NJ
07052-3022
US

V. Phone/Fax

Practice location:
  • Phone: 973-705-4914
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAJAVELU DHARMARAJ
Title or Position: COO
Credential:
Phone: 203-648-5087