Healthcare Provider Details

I. General information

NPI: 1336148998
Provider Name (Legal Business Name): CENTRAL RADIOLOGY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTRAL AVE
EAST ORANGE NJ
07018-2819
US

IV. Provider business mailing address

300 CENTRAL AVE
EAST ORANGE NJ
07018-2819
US

V. Phone/Fax

Practice location:
  • Phone: 973-266-4415
  • Fax: 973-266-8482
Mailing address:
  • Phone: 973-266-4415
  • Fax: 973-266-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. SHIELA SONALKAR
Title or Position: HEAD RADIOLOGIST
Credential: M.D.
Phone: 973-266-4415