Organization
CARISK IMAGING IPA, LLC
Active
Other names
Atlantic Imaging Group-IPA, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN M MAHONEY (PRESIDENT)
(770) 865-3222
Entity
Organization
Contact information
Practice address
25A HANOVER RD STE 201, FLORHAM PARK, NJ 07932-1407
(973) 451-9415
(973) 451-9541
Mailing address
25A HANOVER RD STE 201, FLORHAM PARK, NJ 07932-1407
(973) 451-9415
(973) 451-9541
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
12/17/2012
Last updated
06/22/2021
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