Organization

Prime Radiology, Llc

Legal Business Name

Prime Radiology, Llc

NPI Number

1164437547

NPI Type

Organization

Enumeration Date

07/31/2006

Specialties

(Taxonomies)

Contact
Information

Purpose

Mailing
Location

Address

66 W GILBERT ST
111 CENTRAL AVE

City

Tinton Falls
Newark

State

NJ
NJ

Postal Code

07701-4947
07102-1909

Country

US
US

Telephone Number

(732) 212-0051
(973) 877-5287

Authorized Official

Name

Dr. Suresh Mody

Title or Position

PRESIDENT

Telephone Number

(973) 877-5287

Identifiers

Identifier

8112304
1171435
0095270001
1943299
J11285
CG5834
A2021347
WT154

Identifier State

NJ
NJ
NJ
NJ
NJ
NJ
NJ
NJ

Identifier Issuer

Unknown
HORIZON NJ HEALTH
AMERIHEALTH
UNITED HEALTH CARE
HEALTH NET
RAILROAD MEDICARE
OXFORD
WELLCHOICE

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/21/2022

Provider Address