Provider Demographics
NPI:1336136662
Name:RADIOLOGY ASSOCIATES OF RIDGEWOOD P A
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF RIDGEWOOD P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-445-8822
Mailing Address - Street 1:20 FRANKLIN TPKE
Mailing Address - Street 2:
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1749
Mailing Address - Country:US
Mailing Address - Phone:201-445-8822
Mailing Address - Fax:201-447-7058
Practice Address - Street 1:20 FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1749
Practice Address - Country:US
Practice Address - Phone:201-445-8822
Practice Address - Fax:201-447-7058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-03
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22688261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCE2023Medicare PIN
441989Medicare PIN