Garden State Advanced Imaging, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

GARDEN STATE ADVANCED IMAGING, LLC

Practice address

147 W Central Ave
Bergenfield, NJ 07621-1209

Phone

(201) 294-1426

Fax

(201) 261-6276

NPI assigned

Dec 2, 2009

Organization subpart

No

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

Authorized official

Name

Roger H. Coletti, MD

Title

President

Phone

(201) 294-1426

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1336477322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 675",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076210675",
            "telephone_number": "201-294-1426",
            "fax_number": "201-261-6276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 W CENTRAL AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211209",
            "telephone_number": "201-294-1426",
            "fax_number": "201-261-6276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE ADVANCED IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "COLETTI",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-294-1426",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Bergenfield, NJ
• Providers in Bergenfield, 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 Dec 16, 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.