Provider Demographics
NPI:1679762363
Name:SSP PARTNERS, LLC
Entity Type:Organization
Organization Name:SSP PARTNERS, LLC
Other - Org Name:DBA MEDICAL IMAGING OF WASHINGTON TOWNSHIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.O.O., E.V.P.
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:J
Authorized Official - Last Name:PIAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-393-9101
Mailing Address - Street 1:411 ROUTE 17 SOUTH
Mailing Address - Street 2:SUITE 410
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604
Mailing Address - Country:US
Mailing Address - Phone:201-393-9101
Mailing Address - Fax:201-393-9105
Practice Address - Street 1:900 ROUTE 168
Practice Address - Street 2:SUITE G
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-3233
Practice Address - Country:US
Practice Address - Phone:856-232-7474
Practice Address - Fax:856-232-3834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ121075Medicare PIN