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General NPI Number Information
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NPI Number | 1841598638
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Entity Type | Organization
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Legal Business Name | ENTERPRISE RADIATION ONCOLOGY OF NEW JERSEY, LLC
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Dates
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Enumeration Date | 03/03/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 1 CLARA MAASS DR RADIATION ONCOLOGY DEPARTMENT
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3550
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Country | US
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Telephone | 973-450-2270
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Fax | 973-844-4904
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Provider Business Mailing Address
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Address Line | 1 CLARA MAASS DR RADIATION ONCOLOGY DEPARTMENT
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3550
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Country | US
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Telephone | 973-450-2270
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Fax | 973-844-4904
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PERRY S WILLIAMS
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Credential | M.D.
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Telephone | 973-450-2270
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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 | 25MA07298200
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License Number State | NJ
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