Provider Demographics
NPI:1306845110
Name:MOHSIN, JAMIL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:
Last Name:MOHSIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:SOUTH JERSEY RADIOLOGY ASSOCIATES, PA
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7710
Mailing Address - Country:US
Mailing Address - Phone:856-770-0504
Mailing Address - Fax:856-770-0395
Practice Address - Street 1:100 CARNIE BLVD
Practice Address - Street 2:SOUTH JERSEY RADIOLOGY ASSOCIATES, PA SUITE B-5
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4512
Practice Address - Country:US
Practice Address - Phone:856-751-0123
Practice Address - Fax:856-751-0535
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA073811002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1159609OtherHORIZON NJ HEALTH
360004394OtherRAILROAD MEDICARE
MO1545274OtherHIGHMARK PA BLUE SHIELD
NJ8783900Medicaid
A3738029OtherOXFORD HEALTH
2097367000OtherAMERIHEALTH
2188068OtherUNITED HEALTHCARE
5677573OtherAETNA
MO1545274OtherPREMIER BLUE
2097367000OtherAMERIHEALTH
NJ8783900Medicaid