Organization Active NPI

Garden State MRI Corp

Doing business as eastlantic diagnostic institute

  • Diagnostic Radiology Physician
  • Vineland, NJ
National Provider Identifier
1497700702
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
25MA05144800 Issued in NJ
Legal business name
GARDEN STATE MRI CORP
Doing business as
eastlantic diagnostic institute
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
Last updated
Mar 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X 25MA05144800 NJ Primary

Addresses

Primary practice location

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

Mailing address

PO Box 1444
Vineland, NJ 08362-1444
Phone (856) 794-2337

Other names 1

  • eastlantic diagnostic institute Doing business as

National Provider Directory

National Provider Directory

Locations

1470 S Main Rd
Bldg 2
Vineland, NJ 08360
Phone (856) 690-0300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "eastlantic diagnostic institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vineland, NJ

Sources for this page

  • 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.