Basic Information
| Provider Information | |||||||||
| NPI: | 1184149031 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTERDON AMBULATORY SERVICES LLC | ||||||||
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| OtherOrganizationName: | HUNTERDON ADVANCED IMAGING AT BRIDGEWATER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 WESCOTT DR | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088224603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082375595 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1121 ROUTE 22 WEST | ||||||||
| Address2: | STE 103 | ||||||||
| City: | BRIDGEWATER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088072982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087886429 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2017 | ||||||||
| LastUpdateDate: | 04/30/2018 | ||||||||
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| AuthorizedOfficialLastName: | HOSKINS | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 9087886429 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HUNTERDON MEDICAL CENTER | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.