Provider Demographics
NPI:1346249174
Name:GAMMA-ELECTRON RADIATION ONCOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:GAMMA-ELECTRON RADIATION ONCOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-754-7711
Mailing Address - Street 1:PO BOX 4127
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-0127
Mailing Address - Country:US
Mailing Address - Phone:908-754-7711
Mailing Address - Fax:908-754-8885
Practice Address - Street 1:33 OVERLOOK RD
Practice Address - Street 2:L-05
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3570
Practice Address - Country:US
Practice Address - Phone:908-522-2871
Practice Address - Fax:908-522-5628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA297602085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2898900Medicaid
NJ2898900Medicaid