Provider Demographics
NPI:1578741666
Name:THE RADIOLOGY GROUP OF NEW JERSEY LLC
Entity type:Organization
Organization Name:THE RADIOLOGY GROUP OF NEW JERSEY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE STAFF
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:TRACEY
Authorized Official - Last Name:SIDOTI
Authorized Official - Suffix:
Authorized Official - Credentials:OFFICE STAFF
Authorized Official - Phone:973-334-1770
Mailing Address - Street 1:50 CHERRY HILL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1101
Mailing Address - Country:US
Mailing Address - Phone:973-334-1770
Mailing Address - Fax:973-334-2217
Practice Address - Street 1:50 CHERRY HILL RD
Practice Address - Street 2:SUITE 206
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054
Practice Address - Country:US
Practice Address - Phone:973-334-1770
Practice Address - Fax:973-334-2217
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE RADIOLOGY GROUP OF NEW JERSEY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-31
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4807220001Medicare NSC