KM Radiology, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

25MB07370200 Issued in NJ

Legal business name

KM RADIOLOGY, LLC

Practice address

23 Mountainview CT
Totowa, NJ 07512-1654

Phone

(973) 595-7112

NPI assigned

Aug 13, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ketang H Modi, D.O.

Title

Managing Member

Phone

(973) 595-7112

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1295040269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MOUNTAINVIEW CT",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121654",
            "telephone_number": "973-595-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MOUNTAINVIEW CT",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075121654",
            "telephone_number": "973-595-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KM RADIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "KETANG",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "973-595-7112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NJ",
            "license": "25MB07370200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID#",
            "identifier": "059431BSQ",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1396736468",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8900507",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manal Khalil, DPT
• Faria Khan
• Nadira Jasmine Khan, PA
• Grace Khezam
• Michael A. Klele, M.D.
• Edyta Kolbusz, APN
• David A. Kozloski
• Sarah Krakus, LAC
• Elzbieta B Krynska, M.D.
• Justin Kuriyilel, PHARMD

• Radiology Clinic/Center in Totowa, NJ
• Providers in Totowa, NJ by specialty
• Radiology Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; 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.