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General NPI Number Information
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NPI Number | 1083007793
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Entity Type | Individual
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Provider Name | JULIAN INFANTINO
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Gender | Male
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Dates
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Enumeration Date | 03/05/2015
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Last Update Date | 03/05/2015
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Provider Practice Location Address
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Address Line | 6 BETTY CT
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2026
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Country | US
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Telephone | 201-681-5920
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BETTY CT
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-2026
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Country | US
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Telephone | 201-681-5920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | R000185-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | 473120
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License Number State | NY
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