NPIMap

Organization Active NPI

Kimrad LLC

  • Radiation Oncology Physician
  • Lakewood, NJ
National Provider Identifier
1073734877
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
KIMRAD LLC
Practice address
101 Prospect St
Suite 111
Lakewood, NJ 08701-5020
Phone
(732) 363-2699
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph Lattanzi, MD
Title
Partner
Phone
(732) 363-2699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X NJ Primary

Addresses

Primary practice location

101 Prospect St
Suite 111
Lakewood, NJ 08701-5020

Mailing address

1020A Boal Ave
Boalsburg, PA 16827-1509
Phone (814) 237-8627

National Provider Directory

National Provider Directory

Locations

101 Prospect St
Ste 111
Lakewood, NJ 08701
Phone (732) 363-2699

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1073734877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020A BOAL AVE",
            "city": "BOALSBURG",
            "state": "PA",
            "postal_code": "168271509",
            "telephone_number": "814-237-8627",
            "fax_number": "814-238-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROSPECT ST",
            "address_2": "SUITE 111",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015020",
            "telephone_number": "732-363-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMRAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LATTANZI",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "732-363-2699",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.