Provider Demographics
NPI:1124177159
Name:SLR DIAGNOSTIC RADIOLOGY, P.C.
Entity type:Organization
Organization Name:SLR DIAGNOSTIC RADIOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-830-3122
Mailing Address - Street 1:10 EXCHANGE PL
Mailing Address - Street 2:WSBS-14TH FLOOR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3918
Mailing Address - Country:US
Mailing Address - Phone:201-830-8312
Mailing Address - Fax:201-200-0838
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:DEPT OF RADIOLOGY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:201-830-3122
Practice Address - Fax:201-200-0838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLR DIAGNOSTIC RADIOLOGY, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-09
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic NeuroimagingGroup - Single Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Single Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Single Specialty
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Single Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty