1669425096 NPI number — ASSOCIATED RADIOLOGISTS PA

Table of content: (NPI 1669425096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669425096 NPI number — ASSOCIATED RADIOLOGISTS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATED RADIOLOGISTS PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669425096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
239 ROUTE 22 EAST , SUITE 302
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREEN BROOK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08812-1916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-769-1262
Provider Business Mailing Address Fax Number:
908-279-7221

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
239 ROUTE 22 EAST
Provider Second Line Business Practice Location Address:
SUITE 302
Provider Business Practice Location Address City Name:
GREEN BROOK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08812-1916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-968-4899
Provider Business Practice Location Address Fax Number:
732-968-8096
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CASEY
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
732-968-1500

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 41241 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 12M . This is a "CARECORE NATIONAL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2645301 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: CC8391 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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