Organization
MRI OF WOODBRIDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEO FONTANA M.D. (MEDICAL DIRECTOR)
(732) 574-0742
Entity
Organization
Contact information
Practice address
1500 SAINT GEORGES AVE, AVENEL, NJ 07001-1000
(732) 574-0742
(732) 574-0143
Mailing address
PO BOX 828393, PHILADELPHIA, PA 19182-8393
(732) 381-8686
(732) 499-7724
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
22624
NJ
261QR0200X
Radiology Clinic/Center
Primary
22624
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0268620000
AMERIHEALTH
NJ
01
—
1166754
HORIZON NJ HEALTH
NJ
01
—
134438XX
PREFERRED CARE
NJ
01
—
188501
AMERIGROUP
NJ
01
—
1K2970
HEALTHNET
NJ
01
—
2308288
AETNA
NJ
01
—
343114
KEYSTONE HEALTH PLAN
NJ
01
—
347671200
US DEPARTMENT OF LABOR
NJ
01
—
4199032
GHI
NJ
01
—
A2539097
OXFORD
NJ
01
—
CH3126
PALMETTO GBA RAILROAD MED
NJ
Enumeration date
04/20/2006
Last updated
05/12/2014
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