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General NPI Number Information
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NPI Number | 1366513830
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Entity Type | Organization
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Legal Business Name | PENN IMAGING ASSOCIATES PC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 1930 STATE ROUTE 59
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City | KENT
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State | OH
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Zip | 44240-4112
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Country | US
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Telephone | 724-656-4127
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Fax | 724-656-4165
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Provider Business Mailing Address
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Address Line | 1675 E MAIN ST BOX 328
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City | KENT
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State | OH
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Zip | 44240-5818
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Country | US
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Telephone | 330-677-3632
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Fax | 330-677-8770
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT JAMES COOK II
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Credential | MD
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Telephone | 330-677-3632
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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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