Healthcare Provider Details

I. General information

NPI: 1659374684
Provider Name (Legal Business Name): NYDIC OPEN MRI OF AMERICA-BOARDMAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1449 BOARDMAN CANFIELD RD STE 140
BOARDMAN OH
44512-8070
US

IV. Provider business mailing address

100 PARAGON DR STE 200
MONTVALE NJ
07645-1718
US

V. Phone/Fax

Practice location:
  • Phone: 330-965-7370
  • Fax: 330-965-7377
Mailing address:
  • Phone: 201-573-8080
  • Fax: 201-505-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number0838-IC
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

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