MEDICARE: CENTRAL IMAGING ASSOCIATES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	22855	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093819609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL IMAGING ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	514 JOYCE ST
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-1411
Country	:	US
Telephone Number	:	973-672-3334
Fax Number	:	973-672-2002

Provider Business Practice Location Address
First Line	:	514 JOYCE ST
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-1411
Country	:	US
Telephone Number	:	973-672-3334
Fax Number	:	973-672-2002

Authorized Official
Title or Position	:	CEO
Name	:	MR. NICHOLAS GUERRIERI
Credential	:
Telephone Number	:	973-672-3334

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	04/11/2008

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