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General NPI Number Information
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NPI Number | 1053344374
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Entity Type | Organization
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Legal Business Name | CLIFTON RADIOLOGIST ASSOCIATES
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1117 RTE 46 E
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City | CLIFTON
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State | NJ
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Zip | 07013
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Country | US
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Telephone | 973-778-0201
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Fax | 973-778-0279
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Provider Business Mailing Address
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Address Line | 1117 RTE 46 E
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City | CLIFTON
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State | NJ
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Zip | 07013
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Country | US
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Telephone | 973-778-0201
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Fax | 973-778-0279
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. COREY WEINER
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Credential | MD
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Telephone | 973-778-0201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 23283
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License Number State | NJ
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