Provider Demographics
NPI:1245269935
Name:BREAST IMAGING & BIOPSY SPECIALISTS
Entity type:Organization
Organization Name:BREAST IMAGING & BIOPSY SPECIALISTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-571-9100
Mailing Address - Street 1:300 STATE ROUTE 35
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2216
Mailing Address - Country:US
Mailing Address - Phone:732-571-9100
Mailing Address - Fax:732-571-9650
Practice Address - Street 1:300 STATE ROUTE 35
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-2216
Practice Address - Country:US
Practice Address - Phone:732-571-9100
Practice Address - Fax:732-571-9650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
228016OtherPTAN