Provider Demographics
NPI:1750493326
Name:NORTH JERSEY RADIATION ONCOLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:NORTH JERSEY RADIATION ONCOLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERSKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-754-2683
Mailing Address - Street 1:98 FORD RD
Mailing Address - Street 2:SUITE 3-H
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-1374
Mailing Address - Country:US
Mailing Address - Phone:973-625-3366
Mailing Address - Fax:973-625-0349
Practice Address - Street 1:703 MAIN ST
Practice Address - Street 2:RADIATION ONCOLOGY DEPT.
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2621
Practice Address - Country:US
Practice Address - Phone:973-754-2683
Practice Address - Fax:973-754-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA378362085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6065708Medicaid
NJ6065708Medicaid