Organization
PRIME RADIOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURESH P MODY MD (PRESIDENT)
(973) 877-5287
Entity
Organization
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5287
Mailing address
66 W GILBERT ST, 2ND FLOOR, TINTON FALLS, NJ 07701-4947
(732) 212-0051
(732) 212-0052
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
NJ
2085N0700X
Neuroradiology Physician
—
NJ
2085N0904X
Nuclear Radiology Physician
—
NJ
2085R0202X
Diagnostic Radiology Physician
—
NJ
2085R0205X
Radiological Physics Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0095270001
AMERIHEALTH
NJ
01
—
1171435
HORIZON NJ HEALTH
NJ
01
—
1943299
UNITED HEALTH CARE
NJ
05
—
8112304
—
NJ
01
—
A2021347
OXFORD
NJ
01
—
CG5834
RAILROAD MEDICARE
NJ
01
—
J11285
HEALTH NET
NJ
01
—
WT154
WELLCHOICE
NJ
Enumeration date
07/31/2006
Last updated
09/11/2025
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