Provider Demographics
NPI:1679529044
Name:EAST HUDSON MEDICAL PA
Entity type:Organization
Organization Name:EAST HUDSON MEDICAL PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUBA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-810-1151
Mailing Address - Street 1:250 GORGE RD
Mailing Address - Street 2:APT 27J
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1301
Mailing Address - Country:US
Mailing Address - Phone:908-810-1151
Mailing Address - Fax:
Practice Address - Street 1:1865 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3502
Practice Address - Country:US
Practice Address - Phone:908-810-1151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72077174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI20265Medicare UPIN