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General NPI Number Information
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NPI Number | 1376649798
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Entity Type | Organization
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Legal Business Name | MIDWAY RADIOLOGY ASSOCIATES
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 856 S WHITE HORSE PIKE STE C-6
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City | HAMMONTON
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State | NJ
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Zip | 08037-2032
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Country | US
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Telephone | 609-561-9729
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Fax | 609-567-8178
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Provider Business Mailing Address
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Address Line | PO BOX 750
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City | HAMMONTON
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State | NJ
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Zip | 08037-0750
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Country | US
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Telephone | 609-561-9729
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Fax | 609-567-8178
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ROSEANN KENNEDY
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Credential |
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Telephone | 609-561-3095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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