Organization
OPEN MRI OF PERTH AMBOY, LLC
Active
Other names
Raritan Bay Medical Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IVETTE CUEVAS RN (FACILITY ADMINISTRATOR)
(732) 721-5501
Entity
Organization
Contact information
Practice address
551 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3658
(732) 442-4240
(732) 442-5404
Mailing address
PO BOX 3069, SOUTH AMBOY, NJ 08879-3069
(732) 721-5501
(732) 721-7890
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
22565
NJ
261Q00000X
Clinic/Center
Primary
22565
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22565
DEPT OF HEALTH/HUMAN SER
NJ
05
—
8013403
—
NJ
Enumeration date
12/23/2005
Last updated
05/18/2009
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