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General NPI Number Information
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NPI Number | 1578194361
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Entity Type | Organization
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Legal Business Name | CJ IMAGING SERVICES, PSC
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 63 CALLE CRUZ ORTIZ STELLA S
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City | HUMACAO
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State | PR
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Zip | 00791-3334
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Country | US
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Telephone | 787-852-0920
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Fax | 787-852-7770
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Provider Business Mailing Address
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Address Line | PO BOX 9132
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City | HUMACAO
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State | PR
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Zip | 00792-9132
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Country | US
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Telephone | 787-852-0920
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Fax | 787-852-7770
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Authorized Official
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Title or Position | PRESIDENT
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Name | CARLOS JOSE NASSAR
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Credential | MD
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Telephone | 787-852-0920
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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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