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General NPI Number Information
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NPI Number | 1770539058
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Entity Type | Organization
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Legal Business Name | 1450 ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1119 HIGHWAY 77 SUITE 2C
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City | BRIDGETON
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State | NJ
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Zip | 08302-3649
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Country | US
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Telephone | 856-453-1555
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Fax | 856-453-0255
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Provider Business Mailing Address
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Address Line | 1550 E CHESTNUT AVE BUILDING 4, SUITE C
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City | VINELAND
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State | NJ
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Zip | 08361-8485
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Country | US
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Telephone | 856-794-8664
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Fax | 856-794-2671
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Authorized Official
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Title or Position | PARTNER
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Name | DR. SATISH SHAH
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Credential | M.D.
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Telephone | 856-794-8664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 23367
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License Number State | NJ
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