Healthcare Provider Details

I. General information

NPI: 1437125226
Provider Name (Legal Business Name): ROSELAND MEDICAL IMAGING PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 CEDAR GROVE LANE SUITE 108
SOMERSET NJ
08873
US

IV. Provider business mailing address

107 CEDAR GROVE LANE SUITE 108
SOMERSET NJ
08873
US

V. Phone/Fax

Practice location:
  • Phone: 732-560-7172
  • Fax: 732-560-7181
Mailing address:
  • Phone: 732-560-7172
  • Fax: 732-560-7181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number22480
License Number StateNJ

VIII. Authorized Official

Name: DR. AMSAN ZAFAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 732-560-7172