Provider Demographics
NPI:1760436588
Name:RADIOLOGY CONSULTANTS OF NEW JERSEY, INC
Entity Type:Organization
Organization Name:RADIOLOGY CONSULTANTS OF NEW JERSEY, INC
Other - Org Name:RADCON
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER, PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:F
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-608-1350
Mailing Address - Street 1:305 FELLOWSHIP RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-1232
Mailing Address - Country:US
Mailing Address - Phone:856-608-1350
Mailing Address - Fax:
Practice Address - Street 1:305 FELLOWSHIP RD
Practice Address - Street 2:SUITE 111
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1232
Practice Address - Country:US
Practice Address - Phone:856-608-1350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization