Provider Demographics
NPI:1083872436
Name:GARDEN STATE ONCOLOGY,P.C.
Entity Type:Organization
Organization Name:GARDEN STATE ONCOLOGY,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAILJA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-731-2583
Mailing Address - Street 1:6 ALTON WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2858
Mailing Address - Country:US
Mailing Address - Phone:908-731-2583
Mailing Address - Fax:
Practice Address - Street 1:2 ETHEL RD
Practice Address - Street 2:SUITE 206 B
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2839
Practice Address - Country:US
Practice Address - Phone:908-731-2583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-01
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08203700207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08203700OtherSTATE LISENCE