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General NPI Number Information
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NPI Number | 1295772572
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Entity Type | Organization
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Legal Business Name | OPEN MRI OF MORRISTOWN JOINT VENTURE
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 95 MADISON AVE SUITE B04
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6092
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Country | US
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Telephone | 973-539-3373
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Fax | 973-539-7677
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Provider Business Mailing Address
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Address Line | 95 MADISON AVE SUITE B04
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6092
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Country | US
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Telephone | 973-539-3373
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Fax | 973-539-7677
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ROBERT M CLYMER
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Credential |
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Telephone | 973-539-3373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 23095
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License Number State | NJ
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