Healthcare Provider Details

I. General information

NPI: 1437221538
Provider Name (Legal Business Name): DIAGNOSTIC IMAGING OF CLIFTON, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 CLIFTON AVE
CLIFTON NJ
07013-3641
US

IV. Provider business mailing address

1115 CLIFTON AVE
CLIFTON NJ
07013-3641
US

V. Phone/Fax

Practice location:
  • Phone: 973-777-4222
  • Fax:
Mailing address:
  • Phone: 973-777-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. JOHN E. BARATTA
Title or Position: PRESIDENT
Credential:
Phone: 973-777-4222