Jem Breast and Women'S Imaging LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

25MA07886900 Issued in NJ

Legal business name

JEM BREAST AND WOMEN'S IMAGING LLC

Practice address

1275 Highway 35
Middletown, NJ 07748-2040

Phone

(732) 706-5200

Fax

(732) 706-5204

NPI assigned

Oct 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Salvatore Raccuia, MD

Title

Sole MBR

Phone

(732) 706-5200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1851675797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 35",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482040",
            "telephone_number": "732-706-5200",
            "fax_number": "732-706-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 35",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077482040",
            "telephone_number": "732-706-5200",
            "fax_number": "732-706-5204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEM BREAST AND WOMEN'S IMAGING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "RACCUIA",
        "authorized_official_first_name": "SALVATORE",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "732-706-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA07886900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Middletown, NJ
• Providers in Middletown, NJ by specialty
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.