Provider Demographics
NPI:1174892749
Name:NORTH HUDSON RADIOLOGY
Entity type:Organization
Organization Name:NORTH HUDSON RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MIRANDA-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, MPH
Authorized Official - Phone:201-906-4094
Mailing Address - Street 1:600 79TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4964
Mailing Address - Country:US
Mailing Address - Phone:201-725-2976
Mailing Address - Fax:201-861-5924
Practice Address - Street 1:2100 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2127
Practice Address - Country:US
Practice Address - Phone:201-906-4094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)