Healthcare Provider Details

I. General information

NPI: 1265587299
Provider Name (Legal Business Name): AMELIN RADIOLOGY P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLARA MAASS DR
BELLEVILLE NJ
07109-3550
US

IV. Provider business mailing address

5 FRANKLIN AVE SUITE 510
BELLEVILLE NJ
07109-3532
US

V. Phone/Fax

Practice location:
  • Phone: 973-450-2030
  • Fax: 973-751-4456
Mailing address:
  • Phone: 973-751-2011
  • Fax: 973-751-4456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES A HEIMANN
Title or Position: PRESIDENT
Credential: MD
Phone: 973-751-2011