Healthcare Provider Details

I. General information

NPI: 1619923679
Provider Name (Legal Business Name): OPEN MRI & IMAGING OF ROCHELLE PARK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 ROCHELLE AVE
ROCHELLE PARK NJ
07662-3914
US

IV. Provider business mailing address

251 ROCHELLE AVE
ROCHELLE PARK NJ
07662-3914
US

V. Phone/Fax

Practice location:
  • Phone: 201-291-8800
  • Fax: 201-291-0637
Mailing address:
  • Phone: 201-291-8800
  • Fax: 201-291-0637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number23475
License Number StateNJ

VIII. Authorized Official

Name: STEPHEN J CONTE
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 201-291-8800