Provider Demographics
NPI:1164473450
Name:RADIOLOGICAL ASSOCIATES OF GREATER NEW BEDFORD, INC.
Entity Type:Organization
Organization Name:RADIOLOGICAL ASSOCIATES OF GREATER NEW BEDFORD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-997-1515
Mailing Address - Street 1:101 PAGE ST
Mailing Address - Street 2:RADIOLOGY DEPARTMENT
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-3464
Mailing Address - Country:US
Mailing Address - Phone:508-997-1515
Mailing Address - Fax:
Practice Address - Street 1:101 PAGE ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-3464
Practice Address - Country:US
Practice Address - Phone:508-997-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9756515Medicaid
MAM14735Medicare ID - Type Unspecified