Organization
LARCHMONT IMAGING ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY FOGLE (MANAGER OF CREDENTIALING)
(919) 763-1112
Entity
Organization
Contact information
Practice address
210 ARK RD, MOUNT LAUREL, NJ 08054-3188
(609) 261-4500
Mailing address
700 E MOREHEAD ST STE 300, CHARLOTTE, NC 28202-2742
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3226905
—
NJ
Enumeration date
05/23/2006
Last updated
10/01/2024
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