Healthcare Provider Details

I. General information

NPI: 1548281264
Provider Name (Legal Business Name): NIAGARA FALLS OPEN MRI,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4519 MILITARY ROAD OPEN MRI OF NIAGARA FALLS, LLC
NIAGARA FALLS NY
14305
US

IV. Provider business mailing address

22710 EXECUTIVE DR OPEN MRI OF NIAGARA FALLS, LLC
STERLING VA
20166
US

V. Phone/Fax

Practice location:
  • Phone: 716-298-9362
  • Fax: 716-298-9364
Mailing address:
  • Phone: 703-464-0318
  • Fax: 703-464-0319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDA O CARDUCCI
Title or Position: MANAGING MEMBER
Credential:
Phone: 703-437-8330