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General NPI Number Information
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NPI Number | 1578560033
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Entity Type | Organization
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Legal Business Name | ELIZABETH RADIOLOGY ASSOCIATES, P.A.
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 225 WILLIAMSON ST
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City | ELIZABETH
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State | NJ
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Zip | 07202-3625
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Country | US
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Telephone | 732-381-5209
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Fax | 732-574-3488
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Provider Business Mailing Address
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Address Line | 225 WILLIAMSON ST
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City | ELIZABETH
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State | NJ
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Zip | 07202-3625
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Country | US
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Telephone | 732-381-5209
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Fax | 732-574-3488
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Authorized Official
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Title or Position | OWNER/DIRECTOR/ACTIVE, ATTENDING
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Name | EDWARD RITTWEGER
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Credential | M.D.
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Telephone | 732-381-5209
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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 | 25MA03475600
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License Number State | NJ
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