Healthcare Provider Details

I. General information

NPI: 1164536827
Provider Name (Legal Business Name): NATIONAL IMAGING P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 S BROAD ST # 05
PHILADELPHIA PA
19148-2216
US

IV. Provider business mailing address

PO BOX 768
NEW YORK NY
10018-0025
US

V. Phone/Fax

Practice location:
  • Phone: 215-463-1825
  • Fax: 215-463-1828
Mailing address:
  • Phone: 410-360-2233
  • Fax: 410-360-2234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear 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: MR. MAURY L. ROSENBERG
Title or Position: PRESIDENT
Credential:
Phone: 215-564-2800