Healthcare Provider Details
I. General information
NPI: 1811994791
Provider Name (Legal Business Name): RADIOLOGY AFFILIATES OF CENTRAL NEW JERSEY PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2005
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2501 KUSER RD
HAMILTON NJ
08691-3302
US
IV. Provider business mailing address
PO BOX 787512
PHILADELPHIA PA
19178-7512
US
V. Phone/Fax
- Phone: 609-585-8800
- Fax: 609-585-1825
- Phone: 609-689-1600
- Fax: 609-689-1200
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHARLEE
LEBLEU
Title or Position: VICE PRESIDENT
Credential:
Phone: 480-321-7026