Organization
JEM BREAST AND WOMEN'S IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALVATORE RACCUIA MD (SOLE MBR)
(732) 706-5200
Entity
Organization
Contact information
Practice address
1275 HIGHWAY 35, MIDDLETOWN, NJ 07748-2040
(732) 706-5200
(732) 706-5204
Mailing address
1275 HIGHWAY 35, MIDDLETOWN, NJ 07748-2040
(732) 706-5200
(732) 706-5204
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25MA07886900
NJ
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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