Provider Demographics
NPI:1437266566
Name:HILLSBOROUGH RADIOLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:HILLSBOROUGH RADIOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-821-5563
Mailing Address - Street 1:3674 ROUTE 27, HILLSBOROUGH RADIOLOGY ASSOCIATES, LLC
Mailing Address - Street 2:DEPARTMENT B
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824
Mailing Address - Country:US
Mailing Address - Phone:732-821-5563
Mailing Address - Fax:732-821-6675
Practice Address - Street 1:375 ROUTE 206, HILLSBOROUGH RADIOLOGY ASSOCIATES, LLC
Practice Address - Street 2:SUITE 1
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08876
Practice Address - Country:US
Practice Address - Phone:908-874-7600
Practice Address - Fax:908-874-7052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ959178Medicare PIN