Provider Demographics
NPI:1083808901
Name:HUNTERDON RADIOLOGICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:HUNTERDON RADIOLOGICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-806-2635
Mailing Address - Street 1:PO BOX 5388
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-0388
Mailing Address - Country:US
Mailing Address - Phone:908-806-2635
Mailing Address - Fax:908-782-4560
Practice Address - Street 1:2100 WESCOTT DR
Practice Address - Street 2:DEPARTMENT OF MEDICAL IMAGING
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4603
Practice Address - Country:US
Practice Address - Phone:908-788-6640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2835703Medicaid
NJ448496Medicare PIN