Healthcare Provider Details
I. General information
NPI: 1497966352
Provider Name (Legal Business Name): NORTH AMERICAN DIAGNOSTIC IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 SEARS DR 2ND FLOOR
PARAMUS NJ
07652-3539
US
IV. Provider business mailing address
2 SEARS DR 2ND FLOOR
PARAMUS NJ
07652-3539
US
V. Phone/Fax
- Phone: 800-865-0500
- Fax: 201-646-9204
- Phone: 800-865-0500
- Fax: 201-646-9204
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MS.
LYNNE
KOHLMANN
Title or Position: PRACTICE ADMINISTRATOR
Credential: RN,AMT
Phone: 201-646-0520