South Jersey Radiology Associates Pa, NPI 1477551653
Body Imaging Physician in Voorhees, NJ, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1477551653 |
| NPI Entity Type | Organization |
| Provider Name | South Jersey Radiology Associates Pa |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 100 Carnie Blvd, Suite B-5, Voorhees, NJ, US |
| Provider Mailing Address | Po Box 1710, Voorhees, NJ, US, 080437710 |
| Gender | Male |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | Jane Travis Lutz |
| Official Position | MANAGER OF CREDENTIALING |
| Phone | 704-362-5391 |
Group Taxonomy
| Taxonomy Code | 193400000X |
| Taxonomy Name | 193400000X MULTIPLE SINGLE SPECIALTY GROUP |
| Definition | A business group of one or more individual practitioners, all of who practice with the same area of specialization. |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Body Imaging Physician |
| Classification | |
| Group | |
| License No. | 429966 |
| License State | NJ |
| Description | A Radiology doctor of Osteopathy that specializes in Body Imaging. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 00099913000 | AMERIHEALTH - HMO | 01 | |
| 429966 | HIGHMARK PA BLUE SHIELD | 01 | |
| 46043 | CAQH | 01 | |
| 429966 | PREMIER BLUE | 01 | |
| 0016366 | AETNA | 01 | |
| 2612704 | NJ | MEDICAID | 05 |
| CA3660 | RAILROAD MEDICARE | 01 | |
| 1100179 | HORIZON NJ HEALTH | 01 | |
| 429966 | AMERIHEALTH -- PPO | 01 |
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