Provider Demographics
NPI:1982794889
Name:NEW JERSEY RADIOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:NEW JERSEY RADIOLOGY ASSOCIATES, PC
Other - Org Name:MANAHAWKIN OPEN MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-663-5910
Mailing Address - Street 1:101 GREENWOOD AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2627
Mailing Address - Country:US
Mailing Address - Phone:215-663-5910
Mailing Address - Fax:215-663-2451
Practice Address - Street 1:1322 ROUTE 72
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2489
Practice Address - Country:US
Practice Address - Phone:609-978-7900
Practice Address - Fax:609-978-7544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0365483Medicaid
NJ057451Medicare PIN