Provider Demographics
NPI:1841598638
Name:ENTERPRISE RADIATION ONCOLOGY OF NEW JERSEY, LLC
Entity Type:Organization
Organization Name:ENTERPRISE RADIATION ONCOLOGY OF NEW JERSEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-450-2270
Mailing Address - Street 1:1 CLARA MAASS DR
Mailing Address - Street 2:RADIATION ONCOLOGY DEPARTMENT
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3550
Mailing Address - Country:US
Mailing Address - Phone:973-450-2270
Mailing Address - Fax:973-844-4904
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:RADIATION ONCOLOGY DEPARTMENT
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2270
Practice Address - Fax:973-844-4904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA072982002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty