Provider Demographics
NPI:1043647365
Name:STELTON RADIOLOGY CORP
Entity Type:Organization
Organization Name:STELTON RADIOLOGY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DMITRIY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-287-9747
Mailing Address - Street 1:1092 STELTON RD
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-5201
Mailing Address - Country:US
Mailing Address - Phone:732-287-8747
Mailing Address - Fax:
Practice Address - Street 1:1092 STELTON RD
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-5201
Practice Address - Country:US
Practice Address - Phone:732-287-8747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22578261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology