Hudson Surgical Associates

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

HUDSON SURGICAL ASSOCIATES

Practice address

114 Essex St Ste 102
Rochelle Park, NJ 07662-4342

Phone

(212) 203-2146

Fax

(212) 537-0345

NPI assigned

May 28, 2020

Last updated

May 28, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary M. Legg

Title

Credentialing Coordinator

Phone

(347) 584-8903

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1407479165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ESSEX ST STE 102",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624342",
            "telephone_number": "212-203-2146",
            "fax_number": "212-537-0345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ESSEX ST STE 102",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076624342",
            "telephone_number": "212-203-2146",
            "fax_number": "212-537-0345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "LEGG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "347-584-8903"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1003826066",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.