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General NPI Number Information
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NPI Number | 1316246051
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Entity Type | Organization
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Legal Business Name | HUDSON PAIN AND REHAB LLC
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 711 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-3003
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Country | US
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Telephone | 301-520-5151
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Fax | 301-322-9696
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Provider Business Mailing Address
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Address Line | 711 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-3003
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Country | US
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Telephone | 301-520-5151
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Fax | 301-322-9696
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | MS. SUADA AMIN NOOR
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Credential |
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Telephone | 301-322-9495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 216682
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License Number State | MD
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