Organization Active NPI

Raytel Medical Imaging - Woodbury

  • Radiology Clinic/Center
  • Woodbury, NJ
National Provider Identifier
1245317379
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
22993 Issued in NJ
Legal business name
RAYTEL MEDICAL IMAGING - WOODBURY
Practice address
730 N Broad St
Suite 101
Woodbury, NJ 08096-1796
Phone
(800) 367-1095
Fax
(860) 298-6127
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Authorized official

Name
Mr. Jeffrey M Flanegin
Title
President
Phone
(610) 831-1112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 22993 NJ Primary

Addresses

Primary practice location

730 N Broad St
Suite 101
Woodbury, NJ 08096-1796

Mailing address

PO Box 548
Windsor, CT 06095-0548
Phone (800) 367-1095

Other identifiers 1

IdentifierTypeStateIssuer
8708606MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Raytel Medical Imaging - Woodbury3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1245317379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 548",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060950548",
            "telephone_number": "800-367-1095",
            "fax_number": "860-298-6127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N BROAD ST",
            "address_2": "SUITE 101",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080961796",
            "telephone_number": "800-367-1095",
            "fax_number": "860-298-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYTEL MEDICAL IMAGING - WOODBURY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "FLANEGIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-831-1112",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NJ",
            "license": "22993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8708606",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.