Prime Radiology, Llc
Legal Business Name
Prime Radiology, Llc
NPI Number
1164437547
NPI Type
Organization
Enumeration Date
07/31/2006
Specialties
(Taxonomies)Name
Code
2085B0100X
2085R0202X
2085N0700X
2085N0904X
2085R0205X
Primary Taxonomy
No
No
No
No
No
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