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General NPI Number Information
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NPI Number | 1336190784
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Entity Type | Organization
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Legal Business Name | RADIOLOGY ASSOCIATES, PA
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 03/25/2009
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Provider Practice Location Address
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Address Line | 727 NORTH BEERS STREET
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City | HOLMDEL
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State | NJ
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Zip | 07733
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Country | US
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Telephone | 732-381-8686
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Fax | 732-499-7724
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Provider Business Mailing Address
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Address Line | PO BOX 828050
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City | PHILADELPHIA
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State | PA
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Zip | 19182-8050
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Country | US
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Telephone | 866-553-9994
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Fax | 207-347-7401
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Authorized Official
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Title or Position | DIRECTOR
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Name | LEO J FONTANA
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Credential | MD
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Telephone | 732-574-0742
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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 | 25MA05939000
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License Number State | NJ
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