Healthcare Provider Details
I. General information
NPI: 1821447103
Provider Name (Legal Business Name): CLINICAL HEALTH CARE ASSOCIATES OF NEW JERSEY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2016
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1865 ROUTE 70 E RADIOLOGY SUITE 130
CHERRY HILL NJ
08003-2013
US
IV. Provider business mailing address
1865 ROUTE 70 E RADIOLOGY SUITE 130
CHERRY HILL NJ
08003-2013
US
V. Phone/Fax
- Phone: 856-433-2532
- Fax: 856-825-5221
- Phone: 856-433-2535
- Fax: 856-528-5221
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | NJ |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207U00000X |
| Taxonomy | Nuclear Medicine Physician |
| License Number | |
| License Number State | NJ |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | NJ |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name:
STACY
GRECO
Title or Position: SR. ENROLLMENT MANAGER
Credential:
Phone: 223-341-8516