MEDICARE: RADIOLOGY IMAGING ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center	22617	NJ

General Provider Information

NPI Number	:	1568495570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADIOLOGY IMAGING ASSOCIATES

Provider Business Mailing Address
First Line	:	516 HAMBURG TPKE
Second Line	:	SUITE 6
City	:	WAYNE
State	:	NJ
Zip	:	07470-2062
Country	:	US
Telephone Number	:	973-942-2266
Fax Number	:	973-942-0171

Provider Business Practice Location Address
First Line	:	516 HAMBURG TPKE
Second Line	:	SUITE 6
City	:	WAYNE
State	:	NJ
Zip	:	07470-2062
Country	:	US
Telephone Number	:	973-942-2266
Fax Number	:	973-942-0171

Authorized Official
Title or Position	:	RADIOLOGIST
Name	:	DR. JATIN GAJARAWALA
Credential	:	M.D.
Telephone Number	:	973-942-2266

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	06/11/2009

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