Provider Demographics
NPI:1528371275
Name:EAST BRUNSWICK IMAGING ASSOCIATES LLC
Entity type:Organization
Organization Name:EAST BRUNSWICK IMAGING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CENTER MANAGER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBELLONIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-613-6300
Mailing Address - Street 1:647W ROUTE 18 SOUTH
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3747
Mailing Address - Country:US
Mailing Address - Phone:732-613-6300
Mailing Address - Fax:732-626-6638
Practice Address - Street 1:647 ROUTE 18 STE W
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3747
Practice Address - Country:US
Practice Address - Phone:732-613-6300
Practice Address - Fax:732-626-6638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)