Healthcare Provider Details

I. General information

NPI: 1922073394
Provider Name (Legal Business Name): HUNTERDON RADIOLOGICAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 KINGS CT
FLEMINGTON NJ
08822-6019
US

IV. Provider business mailing address

PO BOX 5388
CLINTON NJ
08809-0388
US

V. Phone/Fax

Practice location:
  • Phone: 908-806-8600
  • Fax: 908-806-8646
Mailing address:
  • Phone: 908-806-2635
  • Fax: 908-782-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number23405
License Number StateNJ

VIII. Authorized Official

Name: MS. MARY ELLEN HALPIN
Title or Position: CAO
Credential:
Phone: 908-806-2635