Provider Demographics
NPI:1477509339
Name:SHORT HILLS RADIATION ONCOLOGY ASSOCIATES PC
Entity Type:Organization
Organization Name:SHORT HILLS RADIATION ONCOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-322-5630
Mailing Address - Street 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-5630
Mailing Address - Fax:973-322-5648
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5630
Practice Address - Fax:973-322-5648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9126007Medicaid
NJ0089362Medicaid
NJ7444605Medicaid
NJ7444702Medicaid
NJ9125906Medicaid
NJ9125906Medicaid
NJ7444702Medicaid
NJG69188Medicare UPIN
NJF56690Medicare UPIN
NJ958400Medicare ID - Type Unspecified
NJ097470Medicare ID - Type Unspecified
NJ046211Medicare ID - Type Unspecified
NJ9126007Medicaid
NJ7444605Medicaid