MEDICARE: HUDSON MILESTONES, INC.

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	252Y00000X	Early Intervention Provider Agency
2	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1568707172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON MILESTONES, INC.

Provider Business Mailing Address
First Line	:	365-381 CLENDENNY AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-1168
Country	:	US
Telephone Number	:	201-434-7783
Fax Number	:	201-434-1860

Provider Business Practice Location Address
First Line	:	365-381 CLENDENNY AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07304-1168
Country	:	US
Telephone Number	:	201-434-7783
Fax Number	:	201-434-1860

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MS. DEBORAH LYNN LORENZETTI
Credential	:	MSW
Telephone Number	:	201-434-7783

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	03/05/2013

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