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General NPI Number Information
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NPI Number | 1841243771
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Entity Type | Organization
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Legal Business Name | VALLEY RADIATION ONCOLOGY ASSOC PA
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 223 N VAN DIEN AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2726
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Country | US
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Telephone | 201-634-5403
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Fax | 862-666-9204
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Provider Business Mailing Address
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Address Line | 109 WANAQUE AVE
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City | POMPTON LAKES
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State | NJ
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Zip | 07442-2101
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Country | US
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Telephone | 862-666-9200
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Fax | 862-666-9204
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Authorized Official
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Title or Position | DIRECTOR
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Name | MICHAEL WESSON
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Credential | M.D.
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Telephone | 862-666-9200
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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 |
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License Number State |
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