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General NPI Number Information
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NPI Number | 1386864635
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Entity Type | Organization
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Legal Business Name | OPEN MRI & IMAGING OF NEWARK
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 243 CHESTNUT STREET
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City | NEWARK
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State | NJ
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Zip | 07105-6501
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Country | US
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Telephone | 973-274-0200
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Fax | 973-274-0220
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Provider Business Mailing Address
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Address Line | 243 CHESTNUT STREET
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City | NEWARK
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State | NJ
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Zip | 07105-6501
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Country | US
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Telephone | 973-274-0200
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Fax | 973-274-0220
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BENEDETTO BIGICA
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Credential |
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Telephone | 973-274-0200
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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 | 22479
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License Number State | NJ
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