Organization Active NPI

Shore Imaging, P.C.

  • Radiology Clinic/Center
  • Lakewood, NJ
National Provider Identifier
1174528715
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
22713 Issued in NJ
Legal business name
SHORE IMAGING, P.C.
Doing business as
Shore Imaging, P.C.
Practice address
1166 River Ave
Ste 102
Lakewood, NJ 08701-5600
Phone
(732) 364-9565
Fax
(732) 364-1908
NPI assigned
Jun 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Authorized official

Name
Veronica Karaska
Title
Credentialling
Phone
(732) 364-6004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 22713 NJ Primary

Addresses

Primary practice location

1166 River Ave
Ste 102
Lakewood, NJ 08701-5600

Mailing address

1166 River Ave
Ste 102
Lakewood, NJ 08701-5600
Phone (732) 364-9565

Other identifiers 1

IdentifierTypeStateIssuer
5381002MedicaidNJ

Other names 1

  • SHORE IMAGING, P.C. Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328659200000",
    "number": "1174528715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 RIVER AVE",
            "address_2": "STE 102",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015600",
            "telephone_number": "732-364-9565",
            "fax_number": "732-364-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 RIVER AVE",
            "address_2": "STE 102",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015600",
            "telephone_number": "732-364-9565",
            "fax_number": "732-364-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE IMAGING, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2012-02-08",
        "status": "A",
        "authorized_official_last_name": "KARASKA",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "CREDENTIALLING",
        "authorized_official_telephone_number": "732-364-6004"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NJ",
            "license": "22713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5381002",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHORE IMAGING, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 8, 2012; 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.