Provider Demographics
NPI:1497205090
Name:ADVANCED DIAGNOSTICS OF NEW JERSEY, INC.
Entity Type:Organization
Organization Name:ADVANCED DIAGNOSTICS OF NEW JERSEY, INC.
Other - Org Name:UPRIGHT MRI OF CHERRY HILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-473-1500
Mailing Address - Street 1:7632 CITY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2007
Mailing Address - Country:US
Mailing Address - Phone:215-473-1500
Mailing Address - Fax:215-473-4506
Practice Address - Street 1:701 ROUTE 38
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2955
Practice Address - Country:US
Practice Address - Phone:856-486-9000
Practice Address - Fax:856-486-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23487261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)