Provider Demographics
NPI:1073568309
Name:BTD RADIOLOGY AT SALEM PA
Entity Type:Organization
Organization Name:BTD RADIOLOGY AT SALEM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-339-6054
Mailing Address - Street 1:PO BOX 11028
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17605
Mailing Address - Country:US
Mailing Address - Phone:717-293-3223
Mailing Address - Fax:717-390-2455
Practice Address - Street 1:310 WOODSTOWN RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079
Practice Address - Country:US
Practice Address - Phone:856-339-6054
Practice Address - Fax:856-935-4970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100374VA0Medicare ID - Type Unspecified