Healthcare Provider Details

I. General information

NPI: 1629024682
Provider Name (Legal Business Name): WOMEN'S MAMMOGRAPHY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 STATE ROUTE 31
FLEMINGTON NJ
08822-5744
US

IV. Provider business mailing address

121 STATE ROUTE 31
FLEMINGTON NJ
08822-5744
US

V. Phone/Fax

Practice location:
  • Phone: 908-782-4700
  • Fax: 908-782-3785
Mailing address:
  • Phone: 908-782-4700
  • Fax: 908-782-3785

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: LISA F. FALCON
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 908-782-4700