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General NPI Number Information
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NPI Number | 1710368576
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Entity Type | Organization
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Legal Business Name | BARNERT IMAGING LLC
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 680 BROADWAY SUITE 008
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City | PATERSON
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State | NJ
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Zip | 07514
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Country | US
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Telephone | 973-689-7179
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Fax |
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Provider Business Mailing Address
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Address Line | 680 BROADWAY SUITE 005B
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City | PATERSON
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State | NJ
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Zip | 07514
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Country | US
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Telephone | 848-206-6393
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Fax | 848-208-7212
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | SAIRAMACHANDRA RAO KOLLA
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Credential | M.D
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Telephone | 848-206-9363
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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 |
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License Number State |
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