Organization
GARDEN STATE MRI CORP
Active
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up