Provider Demographics
NPI:1790738102
Name:ADVANCED RADIATION ONCOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:ADVANCED RADIATION ONCOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARDIGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-954-4300
Mailing Address - Street 1:PO BOX 513029
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19175-3029
Mailing Address - Country:US
Mailing Address - Phone:855-709-3112
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:610-954-4300
Practice Address - Fax:610-954-4671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018750460001Medicaid
NJ8870802Medicaid
PACH8569OtherRAILROAD MEDICARE
PA0018750460001Medicaid
NJ238849Medicare PIN