Healthcare Provider Details
I. General information
NPI: 1790652717
Provider Name (Legal Business Name): THE RADIOLOGY GROUP OF NEW JERSEY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2025
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16 US HIGHWAY 206 STE C
STANHOPE NJ
07874-3270
US
IV. Provider business mailing address
16 US HIGHWAY 206 STE C
STANHOPE NJ
07874-3270
US
V. Phone/Fax
- Phone: 908-852-3301
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VISHAL
RUPANI
Title or Position: CEO
Credential:
Phone: 973-801-2739