Provider Demographics
NPI:1427128933
Name:HUDSON HEART GROUP, PC
Entity type:Organization
Organization Name:HUDSON HEART GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
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 1:425 70TH ST
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-2417
Mailing Address - Country:US
Mailing Address - Phone:201-854-0055
Mailing Address - Fax:201-854-2633
Practice Address - Street 1:1265 PATERSON PLANK ROAD
Practice Address - Street 2:SUITE 106A
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:732-380-1222
Practice Address - Fax:732-935-0101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05225300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX ID#