Provider Demographics
NPI:1043563679
Name:PET/CT CENTER OF NEW JERSEY
Entity Type:Organization
Organization Name:PET/CT CENTER OF NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-856-9196
Mailing Address - Street 1:235 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2708
Mailing Address - Country:US
Mailing Address - Phone:973-235-1010
Mailing Address - Fax:973-235-1040
Practice Address - Street 1:235 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2708
Practice Address - Country:US
Practice Address - Phone:973-235-1010
Practice Address - Fax:973-235-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology