Healthcare Provider Details

I. General information

NPI: 1073568309
Provider Name (Legal Business Name): BTD RADIOLOGY AT SALEM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 WOODSTOWN RD
SALEM NJ
08079
US

IV. Provider business mailing address

PO BOX 11028
LANCASTER PA
17605
US

V. Phone/Fax

Practice location:
  • Phone: 856-339-6054
  • Fax: 856-935-4970
Mailing address:
  • Phone: 717-293-3223
  • Fax: 717-390-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KEVIN J BYRNE
Title or Position: PRESIDENT
Credential: MD
Phone: 856-339-6054