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General NPI Number Information
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NPI Number | 1235245119
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Entity Type | Organization
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Legal Business Name | DENVILLE DIAGNOSTICS IMAGING AND OPEN MRI LLC
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 161 EAST MAIN STREET
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City | DENVILLE
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State | NJ
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Zip | 07834
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Country | US
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Telephone | 973-586-1212
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Fax | 973-586-6555
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Provider Business Mailing Address
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Address Line | 161 EAST MAIN STREET
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City | DENVILLE
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State | NJ
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Zip | 07834
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Country | US
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Telephone | 973-586-1212
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Fax | 973-586-6555
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Authorized Official
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Title or Position | CEO
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Name | ANDREIA LIMA
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Credential |
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Telephone | 908-361-7350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | 24073
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 24073
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License Number State | NJ
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