Edgewater Imaging LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

EDGEWATER IMAGING LLC

Practice address

18 Hilliard Ave
Edgewater, NJ 07020-1257

Phone

(803) 673-6355

Fax

(866) 201-1187

NPI assigned

Dec 21, 2015

Last updated

Dec 21, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Preetham Pillarisetty

Title

Ceo

Phone

(803) 673-6355

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1450656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1669837555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 JULIA PL",
            "city": "BUDD LAKE",
            "state": "NJ",
            "postal_code": "078282461",
            "telephone_number": "803-673-6355",
            "fax_number": "866-201-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 HILLIARD AVE",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201257",
            "telephone_number": "803-673-6355",
            "fax_number": "866-201-1187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGEWATER IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-21",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "PILLARISETTY",
        "authorized_official_first_name": "PREETHAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-673-6355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Radiology Clinic/Center in Edgewater, NJ
• Providers in Edgewater, 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 21, 2015; 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.