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General NPI Number Information
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NPI Number | 1184660037
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Entity Type | Organization
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Legal Business Name | IMAGING CONSULTANTS, INC.
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 840 HARRISON AVE
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City | BOSTON
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State | MA
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Zip | 02118-2905
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Country | US
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Telephone | 617-638-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 600 FEDERAL ST
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City | ANDOVER
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State | MA
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Zip | 01810-1039
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Country | US
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Telephone | 978-552-2600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID L. BLOOM
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Credential | MD
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Telephone | 978-552-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 440413
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License Number State | MA
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