Healthcare Provider Details

I. General information

NPI: 1982022984
Provider Name (Legal Business Name): RELIABLE DIAGNOSTICS SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 01/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 MOUNTAIN AVE
HACKETTSTOWN NJ
07840-2390
US

IV. Provider business mailing address

7 WOODLAND RD
FAIRFIELD NJ
07004-1901
US

V. Phone/Fax

Practice location:
  • Phone: 201-410-5595
  • Fax: 973-882-3231
Mailing address:
  • Phone: 201-410-5595
  • Fax: 973-882-3231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD07797100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD07797100
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberD07797100
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License NumberD07797100
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number113563
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number115056
License Number StateNJ
# 7
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number3020
License Number StateNJ

VIII. Authorized Official

Name: DR. ANIRUDH KHANNA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 201-410-5595