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General NPI Number Information
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NPI Number | 1558400309
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Entity Type | Organization
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Legal Business Name | NEWARK DIAGNOSTIC RADIOLOGISTS, PA
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 201 LYONS AVE
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 732-383-4155
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Fax | 732-383-4171
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Provider Business Mailing Address
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Address Line | 201 LYONS AVE
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City | NEWARK
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State | NJ
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Zip | 07112-2027
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Country | US
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Telephone | 732-383-4155
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Fax | 732-383-4171
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | JANEL DIMARIA
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Credential |
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Telephone | 732-383-4155
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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 |
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License Number State | NJ
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