Basic Information
| Provider Information | |||||||||
| NPI: | 1407069925 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RADIOLOGY ASSOCIATES OF HACKETTSTOWN LLC | ||||||||
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| OtherOrganizationName: | IMAGECARE AT HACKETTSTOWN RAH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 57 ROUTE 46 | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | HACKETTSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07840 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9089791621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 57 ROUTE 46 | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | HACKETTSTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 078402695 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9089791621 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 10/03/2020 | ||||||||
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| AuthorizedOfficialLastName: | HINRICHS | ||||||||
| AuthorizedOfficialFirstName: | CLAY | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9089791621 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 10/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1200X | N | Ambulatory Health Care Facilities | Clinic/Center | Magnetic Resonance Imaging (MRI) | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.