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General NPI Number Information
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NPI Number | 1174870323
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Entity Type | Organization
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Legal Business Name | VITAL SONO IMAGING LLC
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 57 LAKEVIEW AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-4041
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Country | US
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Telephone | 732-321-6507
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Fax |
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Provider Business Mailing Address
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Address Line | 48A GRANDVIEW AVE W
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City | EDISON
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State | NJ
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Zip | 08837-2522
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Country | US
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Telephone | 732-321-6507
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | ALTAF A ESSANI
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Credential |
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Telephone | 732-321-6507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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