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General NPI Number Information
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NPI Number | 1255385183
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Entity Type | Organization
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Legal Business Name | RADIOLOGY ASSOCIATES OF BURLINGTON COUNTY P A
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 175 MADISON AVE
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City | MOUNT HOLLY
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State | NJ
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Zip | 08060-2038
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Country | US
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Telephone | 609-267-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 400 FELLOWSHIP RD STE 200
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-3437
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER OF CREDENTIALING
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Name | TIFFANY FOGLE
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Credential |
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Telephone | 919-763-1112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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