Healthcare Provider Details

I. General information

NPI: 1417013731
Provider Name (Legal Business Name): EDISON RADIOLOGY GROUP PA JFK MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 JAMES ST
EDISON NJ
08820-3947
US

IV. Provider business mailing address

PO BOX 3271
INDIANAPOLIS IN
46206-3271
US

V. Phone/Fax

Practice location:
  • Phone: 732-287-1702
  • Fax: 732-287-1705
Mailing address:
  • Phone: 800-208-7069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NOAM ESHKAR
Title or Position: PRESIDENT
Credential: MD
Phone: 800-208-7069