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General NPI Number Information
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NPI Number | 1578698601
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Entity Type | Organization
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Legal Business Name | EAST COAST RADIATION ONCOLOGY ASSOCIATES NEWARK BETH ISRAEL, PA
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 201 LYONS AVE DEPT OF RADIATION ONCOLOGY - E2
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 973-322-4212
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Fax | 973-322-4132
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Provider Business Mailing Address
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Address Line | 201 LYONS AVE DEPT OF RADIATION ONCOLOGY - E2
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 973-322-4212
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Fax | 973-322-4132
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Authorized Official
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Title or Position | RADIATION ONCOLOGIST
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Name | ROBERT A IVKER
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Credential | DO
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Telephone | 973-926-7320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 25MB06193300
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License Number State | NJ
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