Healthcare Provider Details
I. General information
NPI: 1982651923
Provider Name (Legal Business Name): NORTHEAST IMAGING ASSOCIATES OF PHILADELPHIA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7600 CENTRAL AVE RADIOLOGY DEPARTMENT
PHILADELPHIA PA
19111-2442
US
IV. Provider business mailing address
1001 BRIGGS RD SUITE 210
MOUNT LAUREL NJ
08054-4100
US
V. Phone/Fax
- Phone: 215-728-2162
- Fax: 215-728-4883
- Phone: 856-231-4774
- Fax: 856-231-9699
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HOWARD
B.
KESSLER
Title or Position: DIRECTOR
Credential: M.D.
Phone: 215-728-2162