Provider Demographics
NPI:1982858502
Name:CYBER RADIATION ONCOLOGY SRS LLC
Entity Type:Organization
Organization Name:CYBER RADIATION ONCOLOGY SRS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-652-3417
Mailing Address - Street 1:7905 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:MARGATE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08402-1805
Mailing Address - Country:US
Mailing Address - Phone:609-652-3417
Mailing Address - Fax:609-487-0437
Practice Address - Street 1:JIMMIE LEEDS RD
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NJ
Practice Address - Zip Code:08240-9100
Practice Address - Country:US
Practice Address - Phone:609-652-3417
Practice Address - Fax:609-487-0437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ14206142085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty