NPIMap

Organization Active NPI

Medical Park Imaging, PA

  • Diagnostic Radiology Physician
  • Wayne, NJ
National Provider Identifier
1417902446
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MEDICAL PARK IMAGING, PA
Practice address
330 Ratzer Rd
Wayne, NJ 07470-7702
Phone
(973) 696-5770
Fax
(973) 633-1204
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Joung Lee, MD
Title
President
Phone
(973) 696-5770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

330 Ratzer Rd
Wayne, NJ 07470-7702

Mailing address

10335 N Port Washington Rd
Suite 250
Mequon, WI 53092-5763
Phone (262) 240-9870

National Provider Directory

National Provider Directory

Locations

282 US Highway 46
Denville, NJ 07834
Phone (973) 625-3690

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1417902446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10335 N PORT WASHINGTON RD",
            "address_2": "SUITE 250",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925763",
            "telephone_number": "262-240-9870",
            "fax_number": "262-240-9869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 RATZER RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707702",
            "telephone_number": "973-696-5770",
            "fax_number": "973-633-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PARK IMAGING, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-696-5770",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.