Provider Demographics
NPI:1528467610
Name:HUDSON EYE PHYSICIANS AND SURGEONS, LLC
Entity type:Organization
Organization Name:HUDSON EYE PHYSICIANS AND SURGEONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-436-1150
Mailing Address - Street 1:600 PAVONIA AVE
Mailing Address - Street 2:FLOOR 6
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-2929
Mailing Address - Country:US
Mailing Address - Phone:201-963-9187
Mailing Address - Fax:
Practice Address - Street 1:124 AVENUE B
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2071
Practice Address - Country:US
Practice Address - Phone:201-436-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X
NJ207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty