Healthcare Provider Details

I. General information

NPI: 1093867202
Provider Name (Legal Business Name): STAR OPEN MRI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3729 EASTON NAZARETH HWY SUITE 104
EASTON PA
18045-8344
US

IV. Provider business mailing address

3729 EASTON NAZARETH HWY SUITE 104
EASTON PA
18045-8344
US

V. Phone/Fax

Practice location:
  • Phone: 610-559-0300
  • Fax: 610-559-1324
Mailing address:
  • Phone: 610-559-0300
  • Fax: 610-559-1324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: ATUL K AMIN
Title or Position: OWNER
Credential: MD
Phone: 610-559-0300