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General NPI Number Information
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NPI Number | 1578829685
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Entity Type | Organization
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Legal Business Name | SONO IMAGE LLC
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 583 BROADWAY
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City | PATERSON
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State | NJ
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Zip | 07514-2517
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Country | US
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Telephone | 973-357-9900
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Fax | 973-357-9979
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Provider Business Mailing Address
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Address Line | PO BOX 8166
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City | NORTH BERGEN
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State | NJ
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Zip | 07047-8166
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Country | US
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Telephone | 973-357-9900
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Fax | 973-357-9979
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ORESTES SANCHEZ
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Credential | MD
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Telephone | 201-390-1909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 25MA05792400
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License Number State | NJ
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