East Hudson Primary Care, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EAST HUDSON PRIMARY CARE, PC

Practice address

433 57TH St
West New York, NJ 07093-2119

Phone

(201) 863-2620

Fax

(201) 863-4804

NPI assigned

Mar 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Agustin Diaz, MD

Title

President

Phone

(201) 863-2620

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689633661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 57TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932119",
            "telephone_number": "201-863-2620",
            "fax_number": "201-863-4804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 57TH ST",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932119",
            "telephone_number": "201-863-2620",
            "fax_number": "201-863-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST HUDSON PRIMARY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "AGUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-863-2620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8353506",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in West New York, NJ
• Providers in West New York, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.