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General NPI Number Information
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NPI Number | 1497706576
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Entity Type | Organization
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Legal Business Name | VALLEY ADVANCED MRI LLC
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 2403 BUTLER ST
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City | EASTON
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State | PA
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Zip | 18042
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Country | US
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Telephone | 610-258-1200
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Fax | 610-258-1106
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Provider Business Mailing Address
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Address Line | 2403 BUTLER ST
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City | EASTON
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State | PA
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Zip | 18042
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Country | US
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Telephone | 610-258-1200
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Fax | 610-258-1106
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Authorized Official
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Title or Position | CEO OWNER
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Name | MR. JAMES J STUPPINO
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Credential |
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Telephone | 610-258-1200
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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 | 3054017
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License Number State | PA
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