Sam Radiology Services LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

25MA03109900 Issued in NJ

Legal business name

SAM RADIOLOGY SERVICES LLC

Practice address

66 Tanner St
Haddonfield, NJ 08033-2419

Phone

(856) 507-9512

Fax

(856) 507-9516

NPI assigned

Aug 20, 2009

Organization subpart

No

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

Authorized official

Name

Fazlollah Golestaneh, MDNPI 1780785311

Title

Owner/President

Phone

(856) 507-9512

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Fazlollah Golestaneh, MD

  • Diagnostic Radiology Physician
  • Haddonfield, NJ
  • NPI 1780785311
  NPD (past) Authorized official

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250726400000",
    "number": "1295967453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 TANNER ST",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332419",
            "telephone_number": "856-507-9512",
            "fax_number": "856-507-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 TANNER ST",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080332419",
            "telephone_number": "856-507-9512",
            "fax_number": "856-507-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM RADIOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A",
        "authorized_official_last_name": "GOLESTANEH",
        "authorized_official_first_name": "FAZLOLLAH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "856-507-9512",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NJ",
            "license": "25MA03109900",
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NJ",
            "license": "25MA03109900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2323206",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Anthony Ruggerio, D.M.D.
• James J Runfola, MD
• Cheryl Ruper, DPT
• Patricia J Russell
• Alyssa Brooke Rutledge, M.S., CCC-SLP
• Amber Thani Samaroo, PH. D., LCSW
• Ronald Charles Savage, ED.D.
• Dorothy Chandler Saynisch, PHD
• Reena Schaeffer, MD
• Nancy Jean Schweitzer, APN

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Haddonfield, NJ
• Providers in Haddonfield, NJ by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; 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.