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General NPI Number Information
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NPI Number | 1689619546
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Entity Type | Organization
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Legal Business Name | EAST BRUNSWICK OPEN UPRIGHT MRI LLC
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 620 CRANBURY RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4000
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Country | US
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Telephone | 732-698-1717
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Fax | 732-698-2727
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Provider Business Mailing Address
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Address Line | 620 CRANBURY RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4000
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Country | US
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Telephone | 732-698-1717
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Fax | 732-698-2727
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Authorized Official
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Title or Position | CEO
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Name | ANDREIA LIMA
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Credential |
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Telephone | 908-361-7350
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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 | 23103
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License Number State | NJ
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