Provider Demographics
NPI:1548536766
Name:HUDSON HEMATOLOGY ONCOLOGY LLC
Entity type:Organization
Organization Name:HUDSON HEMATOLOGY ONCOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:GELFAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-333-8248
Mailing Address - Street 1:377 JERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4393
Mailing Address - Country:US
Mailing Address - Phone:201-333-8248
Mailing Address - Fax:201-333-8469
Practice Address - Street 1:377 JERSEY AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4393
Practice Address - Country:US
Practice Address - Phone:201-333-8248
Practice Address - Fax:201-333-8469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0296759Medicaid
NJ240439Medicare PIN