Provider Demographics
NPI:1891716882
Name:SAINT JOSEPH'S RADIOLOGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:SAINT JOSEPH'S RADIOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-837-2388
Mailing Address - Street 1:21 PEACE ST
Mailing Address - Street 2:SUITE 251 EAST
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02907-1510
Mailing Address - Country:US
Mailing Address - Phone:401-837-2388
Mailing Address - Fax:401-456-4043
Practice Address - Street 1:200 HIGH SERVICE AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-5113
Practice Address - Country:US
Practice Address - Phone:401-837-2388
Practice Address - Fax:401-456-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RISJ07297Medicaid
MA9734813Medicaid