Healthcare Provider Details

I. General information

NPI: 1033397930
Provider Name (Legal Business Name): DIAGNOSTIC IMAGING ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1117 ROUTE 46
CLIFTON NJ
07013-2449
US

IV. Provider business mailing address

155 STATE ST
HACKENSACK NJ
07601-5419
US

V. Phone/Fax

Practice location:
  • Phone: 201-487-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: HUMARA PARACHA
Title or Position: MEMBER
Credential:
Phone: 732-321-1100