Organization
MID-STATE RADIATION ONCOLOGY ASSOCIATES, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA TEEPLE (BILLING/CREDENTIALING MANAGER)
(732) 512-7990
Entity
Organization
Contact information
Practice address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7167
(732) 698-0116
Mailing address
318 MASTERS LN, HAMPSTEAD, NC 28443-2627
(732) 512-7990
(732) 906-4915
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3224201
—
NJ
Enumeration date
05/26/2006
Last updated
07/21/2022
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