Healthcare Provider Details

I. General information

NPI: 1730025834
Provider Name (Legal Business Name): JMG IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 LAVENTHAL AVE
IRVINGTON NJ
07111-2842
US

IV. Provider business mailing address

26 LAVENTHAL AVE
IRVINGTON NJ
07111-2842
US

V. Phone/Fax

Practice location:
  • Phone: 973-337-2682
  • Fax:
Mailing address:
  • Phone: 973-337-2682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. JEANNIE MARTINEZ-GONZALES
Title or Position: CEO
Credential: RT (R)
Phone: 646-358-6292