Healthcare Provider Details

I. General information

NPI: 1366501637
Provider Name (Legal Business Name): MRI PHYSICIAN ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 02/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 GRANT AVE
PHILADELPHIA PA
19114-1031
US

IV. Provider business mailing address

2451 GRANT AVE
PHILADELPHIA PA
19114-1031
US

V. Phone/Fax

Practice location:
  • Phone: 215-464-8050
  • Fax: 215-673-5767
Mailing address:
  • Phone: 215-464-8050
  • Fax: 215-673-5767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAIME LOUIS CHECKOFF
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 215-464-8050