Provider Demographics
NPI:1679620637
Name:NUCLEAR CARDIOLOGY DIAGNOSTICS
Entity type:Organization
Organization Name:NUCLEAR CARDIOLOGY DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOLK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-287-4252
Mailing Address - Street 1:4 ETHEL RD
Mailing Address - Street 2:SUITE 406A
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2841
Mailing Address - Country:US
Mailing Address - Phone:732-287-4252
Mailing Address - Fax:732-287-0199
Practice Address - Street 1:4 ETHEL RD
Practice Address - Street 2:SUITE 406A
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2841
Practice Address - Country:US
Practice Address - Phone:732-287-4252
Practice Address - Fax:732-287-0199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology