Healthcare Provider Details

I. General information

NPI: 1649232455
Provider Name (Legal Business Name): NYDIC OPEN MRI OF AMERICA-MAHWAH VALLEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 FRANKLIN TPKE SUITE B
MAHWAH NJ
07430-3516
US

IV. Provider business mailing address

100 PARAGON DR SUITE 200
MONTVALE NJ
07645-1718
US

V. Phone/Fax

Practice location:
  • Phone: 201-760-9500
  • Fax: 201-760-0295
Mailing address:
  • Phone: 201-573-8080
  • Fax: 201-775-4306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number22517
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LAWRENCE M. BUCHWALTER
Title or Position: CEO
Credential:
Phone: 201-573-8080