Healthcare Provider Details

I. General information

NPI: 1063527232
Provider Name (Legal Business Name): PRINCETON RADIOLOGY ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/31/2023
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CENTRE DRIVE, PRINCETON RADIOLOGY ASSOCIATES, P.A.
JAMESBURG NJ
08831-5153
US

IV. Provider business mailing address

619 ALEXANDER RD STE 203
PRINCETON NJ
08540-6017
US

V. Phone/Fax

Practice location:
  • Phone: 609-655-1448
  • Fax: 609-655-4016
Mailing address:
  • Phone: 732-821-5563
  • Fax: 732-821-6675

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: MR. MARC ROTHENBERG
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 732-821-5563