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General NPI Number Information
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NPI Number | 1952606923
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Entity Type | Organization
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Legal Business Name | HUDSON PRIMARY CARE PROFESSIONALS
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Dates
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Enumeration Date | 01/21/2011
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 709 NEWARK AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07306-2803
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Country | US
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Telephone | 718-743-7090
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Fax |
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Provider Business Mailing Address
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Address Line | 72 VAN REIPEN AVE PO BOX 234
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City | JERSEY CITY
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State | NJ
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Zip | 07306-2806
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Country | US
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Telephone | 718-743-7090
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN FRITZ
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Credential | DO
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Telephone | 718-743-7090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MB065822
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License Number State | NJ
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