Organization
GARDEN STATE DIAGNOSTIC IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAISAL M SHAH MD (RADIOLOGIST)
(201) 452-4485
Entity
Organization
Contact information
Practice address
6 EARLIN AVENUE, 160, BROWN MILLS, NJ 08015
(609) 836-5319
Mailing address
6 EARLIN AVE STE 160, BROWNS MILLS, NJ 08015-1768
(609) 836-5313
(609) 836-5444
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
11/02/2018
Last updated
02/14/2019
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