MEDICARE: NEW JERSEY DIAGNOSTIC IMAGING & THERAPY, PA

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center	22234	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	:	1881765659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW JERSEY DIAGNOSTIC IMAGING & THERAPY, PA

Provider Business Mailing Address
First Line	:	PO BOX 14068
Second Line	:
City	:	HAUPPAUGE
State	:	NY
Zip	:	11788-0789
Country	:	US
Telephone Number	:	732-840-8300
Fax Number	:	732-840-6453

Provider Business Practice Location Address
First Line	:	198 JACK MARTIN BLVD
Second Line	:	A-3
City	:	BRICK
State	:	NJ
Zip	:	08724-7769
Country	:	US
Telephone Number	:	732-840-8300
Fax Number	:	732-840-6453

Authorized Official
Title or Position	:	VP, MANAGED CARE & CREDENTIALING
Name	:	JACQUELINE MAYER
Credential	:
Telephone Number	:	631-952-5717

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1457935447 — CHRISTINE SHU MD
Practice Location Address:

196 JACK MARTIN BLVD STE A2
BRICK, NJ
08724-7769

Practice Phone: 732-458-4045
Practice Fax:

1548261084 — DR. DANIEL JOSEPH GRASSO DMD
Practice Location Address:

200 JACK MARTIN BLVD , SUITE A-4
BRICK, NJ
08724-7769

Practice Phone: 732-458-5898
Practice Fax: 732-458-5382

1861474256 — PACITA C. SY M.D.
Practice Location Address:

196 JACK MARTIN BLVD , SUITE A-2
BRICK, NJ
08724-7769

Practice Phone: 732-458-4045
Practice Fax: 732-458-4979

1639192461 — DR. STEPHEN HAYES SPECTOR D.D.S.
Practice Location Address:

194 JACK MARTIN BLVD
BRICK, NJ
08724-7769

Practice Phone: 732-458-1400
Practice Fax:

1326250994 — PACITA C. SY, M.D., LLC
Practice Location Address:

196 JACK MARTIN BLVD , OCEAN MEDICAL PARK, BLDG A-2
BRICK, NJ
08724-7769

Practice Phone: 732-458-4045
Practice Fax: 732-458-4979

1639847338 — FAMILY FIRST PRIMARY PHYSICIANS LLC
Practice Location Address:

196 JACK MARTIN BLVD STE A-2
BRICK, NJ
08724-7769

Practice Phone: 732-458-4045
Practice Fax: 732-458-4979

Directions to “NEW JERSEY DIAGNOSTIC IMAGING & THERAPY, PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.