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NPI Code Detail

MEDICARE: 3G RADIOLOGY, LLC

MEDICARE: 3G RADIOLOGY, LLC
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
12085R0202XDiagnostic Radiology Physician25MA06168700NJ

General Provider Information

NPI Number : 1669720520
Entity Type Code : Organization
Provider Name (Legal Business Name) : 3G RADIOLOGY, LLC
Provider Business Mailing Address
First Line : PO BOX 864
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206
Country : US
Telephone Number : 302-634-0259
Fax Number :
Provider Business Practice Location Address
First Line : 1 E NEW YORK AVE
Second Line :
City : SOMERS POINT
State : NJ
Zip : 08244-2340
Country : US
Telephone Number : 201-392-3100
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : LAURA COGAR
Credential :
Telephone Number : 302-634-0259
Provider Enumeration Date : 08/27/2012
Last Update Date : 06/03/2026

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