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General NPI Number Information
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NPI Number | 1073669545
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Entity Type | Organization
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Legal Business Name | ALPHA SCAN IMAGING, LLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 545 GOFFLE RD
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City | WYCKOFF
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State | NJ
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Zip | 07481-2971
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Country | US
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Telephone | 201-689-2111
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Fax | 201-689-2117
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Provider Business Mailing Address
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Address Line | 60 SKYLINE DR
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City | RINGWOOD
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State | NJ
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Zip | 07456-2039
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Country | US
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Telephone | 973-794-0053
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Fax | 973-866-0353
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MEDHAT RAOUF
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Credential | MD
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Telephone | 973-794-0053
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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 |
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License Number State |
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