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General NPI Number Information
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NPI Number | 1124616297
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Entity Type | Organization
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Legal Business Name | BURLINGTON DIAGNOSTIC IMAGING LLC
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Dates
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Enumeration Date | 01/05/2021
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 2800 ROUTE 130 N STE 202
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City | CINNAMINSON
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State | NJ
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Zip | 08077-3035
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Country | US
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Telephone | 215-990-9336
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 ROUTE 130 N # UITE202
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City | CINNAMINSON
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State | NJ
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Zip | 08077-3035
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Country | US
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Telephone | 215-990-9336
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MISS NAZISH N KHAN
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Credential |
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Telephone | 215-990-9336
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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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Taxonomy #2
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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