Provider Demographics
NPI:1396771556
Name:ATLANTIC MEDICAL IMAGING
Entity type:Organization
Organization Name:ATLANTIC MEDICAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:HEMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-878-9729
Mailing Address - Street 1:8025 BLACK HORSE PIKE STE 300
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-2962
Mailing Address - Country:US
Mailing Address - Phone:609-652-8316
Mailing Address - Fax:609-652-7153
Practice Address - Street 1:44 E JIMMIE LEEDS RD STE 101
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9599
Practice Address - Country:US
Practice Address - Phone:609-677-9729
Practice Address - Fax:609-652-6512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2908301Medicaid
101024Medicare ID - Type Unspecified