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General NPI Number Information
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NPI Number | 1265478747
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Entity Type | Organization
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Legal Business Name | TILTON DYNAMIC IMAGING
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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 | 1226 TILTON RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1809
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Country | US
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Telephone | 609-383-2400
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Fax | 609-383-2407
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Provider Business Mailing Address
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Address Line | 1226 TILTON RD
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City | NORTHFIELD
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State | NJ
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Zip | 08225-1809
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Country | US
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Telephone | 609-383-2400
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Fax | 609-383-2407
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. NORMAN BRETTLER
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Credential | MHA
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Telephone | 609-383-2400
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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 | 23214
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License Number State | NJ
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