Healthcare Provider Details

I. General information

NPI: 1003830571
Provider Name (Legal Business Name): SOUTH JERSEY IMAGING ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 ROUTE 38
CHERRY HILL NJ
08002-2955
US

IV. Provider business mailing address

10 SYCAMORE CT
MEDIA PA
19063-2048
US

V. Phone/Fax

Practice location:
  • Phone: 856-486-9000
  • Fax: 856-486-9149
Mailing address:
  • Phone: 215-432-4488
  • Fax: 215-425-1659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE LOUIS RODRIGUEZ
Title or Position: CEO/OWNER
Credential: MD
Phone: 215-425-1500