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General NPI Number Information
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NPI Number | 1912247966
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Entity Type | Organization
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Legal Business Name | SDNJ RADIOLOGY GROUP, LLC
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 02/27/2013
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Provider Practice Location Address
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Address Line | 224 TAYLORS MILLS RD SUITE 110
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City | MANALAPAN
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State | NJ
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Zip | 07726-3281
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Country | US
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Telephone | 732-577-0555
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Fax | 732-577-8555
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Provider Business Mailing Address
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Address Line | 224 TAYLORS MILLS RD SUITE 110
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City | MANALAPAN
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State | NJ
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Zip | 07726-3281
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Country | US
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Telephone | 732-577-0555
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Fax | 732-577-8555
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES COUREY
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Credential | DDS
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Telephone | 732-577-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0008X
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Taxonomy Name | Oral and Maxillofacial Radiology Dentistry
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License Number | 18597
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License Number State | NJ
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