Provider Demographics
NPI:1356392146
Name:HEIGHTS IMAGING ASSOCIATES, PA
Entity type:Organization
Organization Name:HEIGHTS IMAGING ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:JACOBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-546-1177
Mailing Address - Street 1:17 WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1299
Mailing Address - Country:US
Mailing Address - Phone:856-546-1177
Mailing Address - Fax:856-546-0666
Practice Address - Street 1:17 WHITE HORSE PIKE
Practice Address - Street 2:SUITE 9
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1299
Practice Address - Country:US
Practice Address - Phone:856-546-1177
Practice Address - Fax:856-546-0666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ226222085U0001X, 2085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Not Answered2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3400506Medicaid
NJ3400506Medicaid