Healthcare Provider Details
I. General information
NPI: 1043207855
Provider Name (Legal Business Name): WEST MORRIS IMAGING P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2005
Last Update Date: 12/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
66 SUNSET STRIP SUITE 105 MRI OF WEST MORRIS
SUCCASUNNA NJ
07876
US
IV. Provider business mailing address
66 SUNSET STRIP SUITE 105 MRI OF WEST MORRIS
SUCCASUNNA NJ
07876
US
V. Phone/Fax
- Phone: 973-927-1010
- Fax: 972-927-7273
- Phone: 973-927-1010
- Fax: 972-927-7273
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | 23305 |
| License Number State | NJ |
VIII. Authorized Official
Name:
JEFFREY
WEXLER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 973-927-1010