Provider Demographics
NPI:1063572246
Name:HUDSON HEART GROUP, PC
Entity type:Organization
Organization Name:HUDSON HEART GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-854-0055
Mailing Address - Street 1:PO BOX 2566
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-0641
Mailing Address - Country:US
Mailing Address - Phone:201-854-0055
Mailing Address - Fax:201-854-2633
Practice Address - Street 1:425 70TH ST
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-2417
Practice Address - Country:US
Practice Address - Phone:201-854-0055
Practice Address - Fax:201-854-2633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05225300207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8750079OtherAETNA PPO GROUP #
NJ2749194OtherAETNA HMO GROUP #
NJW7H321OtherBC/BS NY GROUP #
NJ2081205005OtherAMERIHEALTH (SECAUCUS) #
NJ2081205001OtherAMERIHEALTH (GUTTENBERG)#
NJ2081205003OtherAMERIHEALTH (NEWARK) #
NJCJ9162OtherRAILROAD MDCR GROUP #
NJ5581702Medicaid
NJ8750079OtherAETNA PPO GROUP #