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General NPI Number Information
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NPI Number | 1528371275
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Entity Type | Organization
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Legal Business Name | EAST BRUNSWICK IMAGING ASSOCIATES LLC
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 10/17/2013
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Provider Practice Location Address
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Address Line | 647 ROUTE 18 STE W
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3747
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Country | US
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Telephone | 732-613-6300
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Fax | 732-626-6638
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Provider Business Mailing Address
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Address Line | 647W ROUTE 18 SOUTH
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3747
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Country | US
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Telephone | 732-613-6300
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Fax | 732-626-6638
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Authorized Official
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Title or Position | CENTER MANAGER/ADMINISTRATOR
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Name | MR. RALPH DEBELLONIA
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Credential |
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Telephone | 732-613-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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