Provider Demographics
NPI:1922169929
Name:HIGH MOUNTAIN RADIOLOGY
Entity Type:Organization
Organization Name:HIGH MOUNTAIN RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:INWHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-636-0700
Mailing Address - Street 1:468 PARISH DR
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4671
Mailing Address - Country:US
Mailing Address - Phone:973-636-0700
Mailing Address - Fax:973-636-0914
Practice Address - Street 1:468 PARISH DR
Practice Address - Street 2:SUITE 6
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-4671
Practice Address - Country:US
Practice Address - Phone:973-636-0700
Practice Address - Fax:973-636-0914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA500492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ501086Medicare PIN