Provider Demographics
NPI:1063637569
Name:EASTON RADIOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:EASTON RADIOLOGY ASSOCIATES, P.C.
Other - Org Name:MRI OF EASTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-258-4055
Mailing Address - Street 1:P.O. BOX 468
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:PA
Mailing Address - Zip Code:18603-0468
Mailing Address - Country:US
Mailing Address - Phone:866-274-7676
Mailing Address - Fax:484-446-8012
Practice Address - Street 1:2690 KINGSTON ROAD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8011
Practice Address - Country:US
Practice Address - Phone:610-258-4055
Practice Address - Fax:610-258-4684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTON RADIOLOGY ASSOCIATES, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-17
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008657240010Medicaid
PA0008657240010Medicaid
039248Medicare PIN