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General NPI Number Information
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NPI Number | 1649697160
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Entity Type | Organization
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Legal Business Name | MARVEL IMAGING INC.
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 05/17/2021
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Provider Practice Location Address
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Address Line | 99 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10016-7419
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Country | US
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Telephone | 718-938-7367
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Fax |
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Provider Business Mailing Address
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Address Line | 576 QUEEN ANNE RD
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City | TEANECK
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State | NJ
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Zip | 07666-3328
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Country | US
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Telephone | 718-938-1157
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Fax | 718-633-9405
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHERNA Z BERG
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Credential |
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Telephone | 718-938-7367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 155850
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License Number State | NY
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