Provider Demographics
NPI:1558711481
Name:WEST ORANGE RADIOLOGY, LLC
Entity Type:Organization
Organization Name:WEST ORANGE RADIOLOGY, LLC
Other - Org Name:IMAGECARE AT WEST ORANGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-361-7350
Mailing Address - Street 1:57 ROUTE 46 STE 209
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2695
Mailing Address - Country:US
Mailing Address - Phone:908-979-1621
Mailing Address - Fax:
Practice Address - Street 1:61 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-5352
Practice Address - Country:US
Practice Address - Phone:973-506-0679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22601261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology