Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Jun 19, 2008
License(s)
245202 (NY), 25MA09118300 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 65 JAMES ST | Edison, NJ 08820-3947 | 732-321-7545 |
| MAILING | PO BOX 223727 | Pittsburgh, PA 15251-2727 | 732-321-7545 |
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