Provider Demographics
NPI:1588639884
Name:HUNTERDON IMAGING, P.A.
Entity Type:Organization
Organization Name:HUNTERDON IMAGING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-806-2635
Mailing Address - Street 1:PO BOX 5388
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-0388
Mailing Address - Country:US
Mailing Address - Phone:908-806-2635
Mailing Address - Fax:908-806-2525
Practice Address - Street 1:1 DOGWOOD DR
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3101
Practice Address - Country:US
Practice Address - Phone:908-735-4477
Practice Address - Fax:908-730-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22486261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22486OtherSTATE LICENSURE
NJ5078202Medicaid
NJ22486OtherSTATE LICENSURE