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General NPI Number Information
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NPI Number | 1437240843
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Entity Type | Organization
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Legal Business Name | NORTH DOVER OPEN MRI LLC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 08/23/2010
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Provider Practice Location Address
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Address Line | 1215 HIGHWAY 70 SUITE 1003
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5947
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Country | US
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Telephone | 732-370-9902
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Fax | 732-370-9908
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Provider Business Mailing Address
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Address Line | 1215 HIGHWAY 70 SUITE 1003
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5947
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Country | US
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Telephone | 732-370-9902
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Fax | 732-370-9908
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. GARY S MOYERS
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Credential |
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Telephone | 732-370-9902
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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 | 24063
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 24063
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License Number State | NJ
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