Healthcare Provider Details

I. General information

NPI: 1477590289
Provider Name (Legal Business Name): DELAWARE OPEN MRI RADIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 FORREST AVE SUITE 105A
DOVER DE
19904-3314
US

IV. Provider business mailing address

101 GREENWOOD AVE SUITE 151
JENKINTOWN PA
19046-2627
US

V. Phone/Fax

Practice location:
  • Phone: 302-734-5800
  • Fax: 302-734-3450
Mailing address:
  • Phone: 215-379-8458
  • Fax: 215-379-8461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA SANCHEZ
Title or Position: CREDENTIALING COORDINATORD
Credential:
Phone: 215-379-8458