Advanced Interventional Radiology Services LLP

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA079791 Issued in NJ

Legal business name

ADVANCED INTERVENTIONAL RADIOLOGY SERVICES LLP

Practice address

176 Palisade Ave
Radiology Dept-FLR 3
Jersey City, NJ 07306-1121

Phone

(201) 420-7070

Fax

(201) 795-8629

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Rundback, M.D.

Title

President

Phone

(201) 420-7070

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447372255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17318",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073077318",
            "telephone_number": "201-420-7070",
            "fax_number": "201-795-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 PALISADE AVE",
            "address_2": "RADIOLOGY DEPT-FLR 3",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073061121",
            "telephone_number": "201-420-7070",
            "fax_number": "201-795-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERVENTIONAL RADIOLOGY SERVICES LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUNDBACK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-420-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA079791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6299806",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.