SAM RADIOLOGY SERVICES LLC (NPI# 1295967453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295967453 |
| Entity Type | Organization |
| Organization Name | SAM RADIOLOGY SERVICES LLC |
| Practice Address |
66 Tanner St Haddonfield NJ 08033-2419 |
| Practice Telephone | 8565079512 |
| Practice Fax Number | 8565079516 |
| Mailing Telephone | 8565079512 |
| Mailing Fax Number | 8565079516 |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |
| Authorized Official Name | FAZLOLLAH GOLESTANEH (OWNER/PRESIDENT) |
| Authorized Official Telephone | 8565079512 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
25MA03109900 | NJ | Ambulatory Health Care Facilities |
| Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 25MA03109900 | NJ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 2323206 | 05 |
| Street Address |
66 TANNER ST |
| City | HADDONFIELD |
| State | NJ |
| Zip Code | 08033-2419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033181458 | Advanced Radiology of Haddonfield Pa | Clinic/Center | 66 Tanner St, Haddonfield, NJ 08033 | 2006-02-02 |
| 1023202033 | University Imaging Center, LLC | Clinic/Center | 66 Tanner St, Haddonfield, NJ 08033-2419 | 2007-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447750641 | Jennifer Agnes Gould | Counselor | Haddonfield Psychiatry, 30 Washington Ave Suite E-1, Haddonfield, NJ 08033 | 2018-02-15 |
| 1073033593 | Bancroft Neurohealth | Clinic/Center | 425 Haddonfield Rd., Haddonfield, NJ 08033 | 2017-06-26 |
| 1063948446 | Bancroft Neurohealth | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30 Kings Court, Haddonfield, NJ 08033 | 2017-05-04 |
| 1568910008 | Garden State Family Chiropractic | Chiropractor | 15 E Euclid Ave Ste A, Haddonfield, NJ 08033 | 2016-09-13 |
| 1982060034 | Cooper University Hospital | Podiatrist | 37 Centre St, Apt 1, Haddonfield, NJ 08033 | 2016-01-05 |
| 1871965020 | Cristina C. Sertway | Nurse Practitioner | 31 Kings Highway East, Second Floor, Haddonfield, NJ 08033 | 2015-10-28 |
| 1225417603 | Winding Way | Day Training, Developmentally Disabled Services | 116 Ellis Street, Haddonfield, NJ 08033 | 2015-05-19 |
| 1528300720 | Linda Paul | Speech-Language Pathologist | 201 South Kings Highway, Haddonfileld, NJ 08033 | 2013-03-26 |
| 1447598685 | Louis George Palena | Counselor | 1409 Route 70e, Alternatives In Counseling, Cherry Hill, NJ 08033 | 2013-01-23 |
| 1316299506 | Carolyn A Fahy | Social Worker | 228 Kings Hwy East Suite 101, Haddonfield, NJ 08033 | 2012-10-11 |
| Find all providers in zip 08033 | ||||
| Taxonomy Code | 335V00000X |
| Grouping | Suppliers |
| Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154812949 | Emergency Mobile Radiology | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 50 S Michigan Ave, Kenilworth, NJ 07033-1739 | 2018-05-29 |
| 1972007334 | Triton Imaging, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 119 Ivy Ln, Tenafly, NJ 07670-2410 | 2018-03-21 |
| 1447633219 | Divine Care Health Staffing LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 170 Bergen Ave Ste B, New Milford, NJ 07646-2806 | 2015-06-29 |
| 1053742874 | Pdi Health LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 221 River St Ste 9, Hoboken, NJ 07030-5990 | 2013-12-04 |
| 1508119660 | Sigl LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 11-06 Fair Lawn Ave, Fair Lawn, NJ 07410-2228 | 2012-10-25 |
| 1346596418 | Mes Diagnostics, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 100 Wood Ave S, Suite 110, Iselin, NJ 08830-2727 | 2012-07-26 |
| 1083974984 | Image Diagnostic Services | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2 Kennedy Boulevard, East Brunswick, NJ 08816 | 2012-05-24 |
| 1417268004 | Reliant Diagnostics, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 200 Winston Dr Apt 2811, Cliffside Park, NJ 07010-3231 | 2010-06-29 |
| 1912138629 | Care Diagnostics Limited Liability Corporation | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 180 Park Ave S, Lakewood, NJ 08701-3556 | 2009-07-29 |
| 1225268600 | Cardiovascular Onsite Imaging LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2 Hancock Ct, Plainsboro, NJ 08536 | 2009-07-21 |
| Find all providers with the same taxonomy | ||||
| City | HADDONFIELD |
| Zip Code | 08033 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.