Provider Demographics
NPI:1538139175
Name:DIAGNOSTIC RADIOLOGY ASSOC.,PA
Entity Type:Organization
Organization Name:DIAGNOSTIC RADIOLOGY ASSOC.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-365-2750
Mailing Address - Street 1:935 ALLWOOD RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1988
Mailing Address - Country:US
Mailing Address - Phone:973-365-2750
Mailing Address - Fax:973-365-9980
Practice Address - Street 1:350 BOULEVARD
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2840
Practice Address - Country:US
Practice Address - Phone:973-365-4300
Practice Address - Fax:973-365-9980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2719606Medicaid
NJ139606Medicare ID - Type Unspecified