Organization
STAT RADIOLOGY LLC
Active
Other names
Brick Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
DUC T TRAN M.D. (MEDICAL DIRECTOR/PARTNER)
(732) 836-9300
Entity
Organization
Contact information
Practice address
1608 ROUTE 88 W, STE 102, BRICK, NJ 08724-3009
(732) 836-9300
(732) 836-9305
Mailing address
1166 RIVER AVE, STE 102, LAKEWOOD, NJ 08701-5600
(732) 364-9565
(732) 364-1908
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
23006
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH4391
RAILROAD
NJ
Enumeration date
06/20/2005
Last updated
07/16/2008
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