Provider Demographics
NPI:1548815657
Name:SMILES ON THE HUDSON PC
Entity type:Organization
Organization Name:SMILES ON THE HUDSON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENBLAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-328-7059
Mailing Address - Street 1:1115 BRIAR WAY
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-6311
Mailing Address - Country:US
Mailing Address - Phone:201-328-7059
Mailing Address - Fax:
Practice Address - Street 1:125 RIVER RD STE 104
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1002
Practice Address - Country:US
Practice Address - Phone:201-941-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty