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General NPI Number Information
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NPI Number | 1245300094
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Entity Type | Organization
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Legal Business Name | AMAR N. GULATI, PC- RAYTEL MEDICAL IMAGING
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 3751 ISLAND AVE SUITE 4
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City | PHILADELPHIA
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State | PA
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Zip | 19153-3237
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Country | US
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Telephone | 800-367-1095
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Fax | 860-298-6127
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Provider Business Mailing Address
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Address Line | PO BOX 548
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City | WINDSOR
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State | CT
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Zip | 06095-0548
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Country | US
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Telephone | 800-367-1095
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Fax | 860-298-6127
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY M FLANEGIN
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Credential |
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Telephone | 610-831-1112
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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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