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NPI Code Detail

MEDICARE: IRVINGTON MEDICAL IMAGING P.C.

MEDICARE: IRVINGTON MEDICAL IMAGING P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1200XMagnetic Resonance Imaging (MRI) Clinic/Center23000NJ

General Provider Information

NPI Number : 1952480659
Entity Type Code : Organization
Provider Name (Legal Business Name) : IRVINGTON MEDICAL IMAGING P.C.
Provider Business Mailing Address
First Line : 285 COIT ST
Second Line :
City : IRVINGTON
State : NJ
Zip : 07111-4013
Country : US
Telephone Number : 973-351-1277
Fax Number : 973-351-1288
Provider Business Practice Location Address
First Line : 285 COIT ST
Second Line :
City : IRVINGTON
State : NJ
Zip : 07111-4013
Country : US
Telephone Number : 973-351-1277
Fax Number : 973-351-1288
Authorized Official
Title or Position : FACILITY ADMINISTRATOR
Name : MR. DEMOLA ADEOTI
Credential :
Telephone Number : 973-351-1277
Provider Enumeration Date : 11/03/2006
Last Update Date : 08/25/2009

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