Healthcare Provider Details

I. General information

NPI: 1154367803
Provider Name (Legal Business Name): UNIVERSITY RADIOLOGY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 03/31/2022
Certification Date: 03/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 CRANBURY RD
EAST BRUNSWICK NJ
08816-3610
US

IV. Provider business mailing address

579A CRANBURY RD
EAST BRUNSWICK NJ
08816-5426
US

V. Phone/Fax

Practice location:
  • Phone: 732-390-0040
  • Fax: 732-390-5383
Mailing address:
  • Phone: 732-390-0040
  • Fax: 732-955-8874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E EPSTEIN
Title or Position: CHAIRMAN
Credential: MD
Phone: 732-390-0040