Organization
PREMIER PET IMAGING OF NEW JERSEY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE MAHONEY II (CHIEF FINANCIAL OFFICER)
(561) 447-0046
Entity
Organization
Contact information
Practice address
119 CHERRY HILL RD, SUITE 100, PARSIPPANY, NJ 07054-1117
(973) 394-0455
(973) 394-0456
Mailing address
PO BOX 343, WICHITA, KS 67201-0343
(316) 262-2015
(316) 262-2407
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261Q00000X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052370
—
NJ
01
—
P00105394
RR MEDICARE
NJ
Enumeration date
04/18/2006
Last updated
10/23/2007
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