Provider Demographics
NPI:1093819609
Name:CENTRAL IMAGING ASSOCIATES, INC
Entity Type:Organization
Organization Name:CENTRAL IMAGING ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-672-3334
Mailing Address - Street 1:514 JOYCE ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-1411
Mailing Address - Country:US
Mailing Address - Phone:973-672-3334
Mailing Address - Fax:973-672-2002
Practice Address - Street 1:514 JOYCE ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-1411
Practice Address - Country:US
Practice Address - Phone:973-672-3334
Practice Address - Fax:973-672-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ228552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0095494Medicaid
NJ0095494Medicaid