MEDICARE: HUDSON NEUROLOGY & PAIN MANGEMENT

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	261QP3300X	Pain Clinic/Center

General Provider Information

NPI Number	:	1629223755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON NEUROLOGY & PAIN MANGEMENT

Provider Business Mailing Address
First Line	:	2983 JFK BLVD
Second Line	:	SUITE 200
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3849
Country	:	US
Telephone Number	:	201-420-6200
Fax Number	:	201-420-6207

Provider Business Practice Location Address
First Line	:	2983 JFK BLVD
Second Line	:	SUITE 200
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-3849
Country	:	US
Telephone Number	:	201-420-6200
Fax Number	:	201-420-6200

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. NABIL M YAZGI
Credential	:
Telephone Number	:	201-420-6200

Provider Enumeration Date	:	11/17/2008
Last Update Date	:	11/17/2008

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