Provider Demographics
NPI:1871549501
Name:EAST COAST RADIATION ONCOLOGY ASSOCIATES PA
Entity type:Organization
Organization Name:EAST COAST RADIATION ONCOLOGY ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:V
Authorized Official - Last Name:IYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-557-8692
Mailing Address - Street 1:PO BOX 689
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-0689
Mailing Address - Country:US
Mailing Address - Phone:814-237-8627
Mailing Address - Fax:814-238-0083
Practice Address - Street 1:99 HIGHWAY 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6423
Practice Address - Country:US
Practice Address - Phone:732-557-2012
Practice Address - Fax:732-557-8028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1080172OtherHORIZON NJ HEALTH
NJ7168403Medicaid
NJ9620221OtherGHI
NJCC9104OtherRR MEDICARE
NJ0970305000OtherAMERIHEALTH HMO
NJ861811OtherAMERIHEALTH PPO
NJ2084944OtherAETNA HMO
NJ9620221OtherGHI