Organization
GARDEN STATE MRI CORP
Active
Other names
eastlantic diagnostic institute
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RALPH DAUITO M.D. (CEO)
(856) 794-2337
Entity
Organization
Contact information
Practice address
1470 S MAIN RD, BUILDING 2, VINELAND, NJ 08360-6588
(856) 690-0300
(856) 205-9925
Mailing address
PO BOX 1444, VINELAND, NJ 08362-1444
(856) 794-2337
(856) 205-9925
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA05144800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-1000769500
AMERICHOICE
—
01
—
0-401564000
AMERIHEALTH
—
01
—
0-49332
CIGNA
—
01
—
101191
MEDICAR E GROUP NUMBER
NJ
01
—
1025244
HORIZON NJ HEALTH
—
01
—
1276753
UNITED HEALTHCARE
—
01
—
1333467
AETNA
—
05
—
1528301
—
NJ
01
—
40184
AMERIGROUP
—
01
—
ANC929
OXFORD
—
Enumeration date
05/24/2006
Last updated
03/11/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us