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General NPI Number Information
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NPI Number | 1780702803
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Entity Type | Organization
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Legal Business Name | CENTRAL JERSEY RADIOLOGISTS
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 2128 KINGS HWY
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City | OAKHURST
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State | NJ
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Zip | 07755
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Country | US
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Telephone | 732-493-8444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 988
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City | NEPTUNE
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State | NJ
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Zip | 07754-0988
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Country | US
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Telephone | 732-493-8444
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Fax | 732-493-4185
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JILL BAER
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Credential |
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Telephone | 732-493-8444
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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 | 22852
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License Number State | NJ
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