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General NPI Number Information
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NPI Number | 1043762792
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Entity Type | Organization
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Legal Business Name | LIFECARE DIAGNOSTIC IMAGING INC
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Dates
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Enumeration Date | 10/28/2016
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Last Update Date | 10/28/2016
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Provider Practice Location Address
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Address Line | 1117 ROUTE 46 SUITE # 102
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City | CLIFTON
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State | NJ
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Zip | 07013-2449
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Country | US
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Telephone | 973-777-8100
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Fax | 973-777-5108
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Provider Business Mailing Address
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Address Line | 1117 ROUTE 46 SUITE # 102
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City | CLIFTON
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State | NJ
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Zip | 07013-2449
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Country | US
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Telephone | 973-777-8100
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Fax | 973-777-5108
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FARIA SALEEM KHAN
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Credential |
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Telephone | 973-470-2533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State | NJ
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