Healthcare Provider Details

I. General information

NPI: 1083808901
Provider Name (Legal Business Name): HUNTERDON RADIOLOGICAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 07/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR DEPARTMENT OF MEDICAL IMAGING
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

PO BOX 5388
CLINTON NJ
08809-0388
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6640
  • Fax:
Mailing address:
  • Phone: 908-806-2635
  • Fax: 908-782-4560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number State

VIII. Authorized Official

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