Provider Demographics
NPI:1326191008
Name:BRAIT PARTNOW MARGOLIN & SHARETTS MDS PA
Entity Type:Organization
Organization Name:BRAIT PARTNOW MARGOLIN & SHARETTS MDS PA
Other - Org Name:ALSO MRI DIAGNOSTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PARTNOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-871-7500
Mailing Address - Street 1:231 VAN SCIVER PARKWAY
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1132
Mailing Address - Country:US
Mailing Address - Phone:609-871-7500
Mailing Address - Fax:609-871-6026
Practice Address - Street 1:231 VAN SCIVER PARKWAY
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1132
Practice Address - Country:US
Practice Address - Phone:609-871-7500
Practice Address - Fax:609-871-6026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ079851OtherPA BLUE SHIELD
363582900OtherUS DEPT OF LABOR W
CN1212OtherRAILROAD MEDICARE
007712900OtherAMERIHEALTH
007712900OtherKEYSTONE HPE
NJBU000005900OtherAMERICHOICE
0002782OtherAETNA
3099890OtherGHI
113941900OtherUS DEPT OF LABOR M
0000F02083OtherHEALTH NET
NJ2811901Medicaid
NJ1035083OtherHORIZON NJ HEALTH
363582900OtherUS DEPT OF LABOR W