Basic Information
| Provider Information | |||||||||
| NPI: | 1073568309 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BTD RADIOLOGY AT SALEM PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11028 | ||||||||
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| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172933223 | ||||||||
| FaxNumber: | 7173902455 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 WOODSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08079 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563396054 | ||||||||
| FaxNumber: | 8569354970 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BYRNE | ||||||||
| AuthorizedOfficialFirstName: | KEVIN | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8563396054 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085B0100X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Body Imaging |
No ID Information.