Provider Demographics
NPI:1366604639
Name:HEALTH DIAGNOSTICS OF NEW JERSEY, LLC
Entity type:Organization
Organization Name:HEALTH DIAGNOSTICS OF NEW JERSEY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:SWAPAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-494-9061
Mailing Address - Street 1:3840 PARK AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2563
Mailing Address - Country:US
Mailing Address - Phone:732-494-9061
Mailing Address - Fax:732-494-5571
Practice Address - Street 1:3499 ROUTE 9
Practice Address - Street 2:NORTH JUNIPER PLAZA
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3258
Practice Address - Country:US
Practice Address - Phone:800-874-2281
Practice Address - Fax:732-494-5960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ225392085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ023777Medicare PIN