Provider Demographics
NPI:1659390870
Name:RADIOLOGY ASSOCIATES OF NEW JERSEY PC
Entity Type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF NEW JERSEY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:LOCKE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-661-5473
Mailing Address - Street 1:2201 CHAPEL AVE W
Mailing Address - Street 2:ATTN: RADIOLOGY DEPT
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2048
Mailing Address - Country:US
Mailing Address - Phone:856-661-5473
Mailing Address - Fax:856-488-6507
Practice Address - Street 1:2201 CHAPEL AVE W
Practice Address - Street 2:ATTN: RADIOLOGY DEPT
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2048
Practice Address - Country:US
Practice Address - Phone:856-661-5473
Practice Address - Fax:856-488-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Single Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0072656Medicaid
NJ093161Medicare ID - Type Unspecified