Provider Demographics
NPI:1568495570
Name:RADIOLOGY IMAGING ASSOCIATES
Entity Type:Organization
Organization Name:RADIOLOGY IMAGING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JATIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAJARAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-942-2266
Mailing Address - Street 1:516 HAMBURG TPKE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2062
Mailing Address - Country:US
Mailing Address - Phone:973-942-2266
Mailing Address - Fax:973-942-0171
Practice Address - Street 1:516 HAMBURG TPKE
Practice Address - Street 2:SUITE 6
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2062
Practice Address - Country:US
Practice Address - Phone:973-942-2266
Practice Address - Fax:973-942-0171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22617261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology