Garden State MRI Corp

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

25MA05144800 Issued in NJ

Legal business name

GARDEN STATE MRI CORP

Practice address

1470 S Main Rd
Building 2
Vineland, NJ 08360-6588

Phone

(856) 690-0300

Fax

(856) 205-9925

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ralph Dauito, M.D.NPI 1073562872

Title

Ceo

Phone

(856) 794-2337

Specialties & licenses 1

Addresses

Other identifiers 10

Other names 1

• eastlantic diagnostic institute Doing business as

Locations

Practitioners 2

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

• Ralph Dauito, MD

  • Diagnostic Radiology Physician
  • Absecon, NJ
  • NPI 1073562872

  Diagnostic Radiology

  NPD (past) Authorized official
• Dallas Aaron Smith Jr., MD

  • Diagnostic Radiology Physician
  • Greensboro, NC
  • NPI 1972507655

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1497700702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1444",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083621444",
            "telephone_number": "856-794-2337",
            "fax_number": "856-205-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 S MAIN RD",
            "address_2": "BUILDING 2",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606588",
            "telephone_number": "856-690-0300",
            "fax_number": "856-205-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE MRI CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "DAUITO",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "856-794-2337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA05144800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE",
            "identifier": "0-1000769500",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "40184",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1333467",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1025244",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1276753",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528301",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0-401564000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0-49332",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAR E GROUP NUMBER",
            "identifier": "101191",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "ANC929",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "eastlantic diagnostic institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shannon B Gallina, LSW
• Quira Galson
• Yuebo Gan, M.D., PH.D.
• Asha J Gandhi, MD
• Carmen Garcia
• Garden State Physician Associates LLC
• Iana Garrick
• Monica M Garton, RPH
• David Gasalberti, M.D.
• Gastroenterology Group of South Jersey P C

• All providers in Vineland, NJ
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.