Healthcare Provider Details

I. General information

NPI: 1861888117
Provider Name (Legal Business Name): ULTRA IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 LANZA AVE STE 10
GARFIELD NJ
07026-3551
US

IV. Provider business mailing address

160 LANZA AVE STE 9
GARFIELD NJ
07026-3551
US

V. Phone/Fax

Practice location:
  • Phone: 973-878-3282
  • Fax: 973-878-1773
Mailing address:
  • Phone: 973-864-7845
  • Fax: 973-878-1773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. BLEDAR BERBERI
Title or Position: OWNER
Credential:
Phone: 973-864-7845