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General NPI Number Information
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NPI Number | 1588636708
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC IMAGING OF BRANDYWINE VALLEY LP
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1238 E LANCASTER AVE
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-3357
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Country | US
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Telephone | 610-518-3428
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Fax |
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Provider Business Mailing Address
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Address Line | 1238 E LANCASTER AVE
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-3357
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Country | US
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Telephone | 610-518-3428
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY D NEWSOME
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Credential |
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Telephone | 888-373-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State | PA
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