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General NPI Number Information
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NPI Number | 1649475997
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Entity Type | Organization
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Legal Business Name | ORANGE COMMUNITY MRI
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 345 HENRY ST SUITE#102
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City | ORANGE
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State | NJ
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Zip | 07050-2500
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Country | US
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Telephone | 973-672-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 345 HENRY STREET SUITE #102
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City | ORANGE
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State | NJ
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Zip | 07050
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Country | US
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Telephone | 973-672-2000
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CHIRAG PATEL
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Credential | BS
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Telephone | 973-672-2000
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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 | 23249
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License Number State | NJ
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