Healthcare Provider Details

I. General information

NPI: 1538100599
Provider Name (Legal Business Name): ASHOKKUMAR R BABARIA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 QUAKERBRIDGE CT
MOORESTOWN NJ
08057-2823
US

IV. Provider business mailing address

208 QUAKERBRIDGE CT
MOORESTOWN NJ
08057-2823
US

V. Phone/Fax

Practice location:
  • Phone: 856-222-9669
  • Fax: 609-383-0376
Mailing address:
  • Phone: 856-222-9669
  • Fax: 609-383-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMA48111
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: