Healthcare Provider Details

I. General information

NPI: 1154501765
Provider Name (Legal Business Name): ECHOSCAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2007
Last Update Date: 11/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CRESTWOOD DR
MADISON NJ
07940-1116
US

IV. Provider business mailing address

2 CRESTWOOD DR
MADISON NJ
07940-1116
US

V. Phone/Fax

Practice location:
  • Phone: 973-919-0855
  • Fax: 973-845-2362
Mailing address:
  • Phone: 973-919-0855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State

VIII. Authorized Official

Name: MR. RUSSELL M RITOTA
Title or Position: TECHNICIAN OWNER
Credential: R.D.C.S.
Phone: 973-919-0855