MEDICARE: HUDSON HEALTH SERVICES ASSOCIATES,PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081N0008X	Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician	25MA07659800	NJ

General Provider Information

NPI Number	:	1104100098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON HEALTH SERVICES ASSOCIATES,PA

Provider Business Mailing Address
First Line	:	3540 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3450
Country	:	US
Telephone Number	:	201-333-2221
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 JOHN F KENNEDY BLVD
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-3450
Country	:	US
Telephone Number	:	201-333-2221
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD HADDAD
Credential	:	M.D.
Telephone Number	:	201-333-2221

Provider Enumeration Date	:	10/10/2011
Last Update Date	:	10/10/2011

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