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General NPI Number Information
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NPI Number | 1760643399
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Entity Type | Organization
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Legal Business Name | TELERAD EXPRESS, LLC
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 23811 CHAGRIN BLVD #114
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City | BEACHWOOD
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State | OH
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Zip | 44122-5525
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Country | US
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Telephone | 216-245-4190
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Fax | 216-378-0035
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Provider Business Mailing Address
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Address Line | 23811 CHAGRIN BLVD #114
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City | BEACHWOOD
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State | OH
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Zip | 44122-5525
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Country | US
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Telephone | 216-245-4190
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Fax | 216-378-0035
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. ETHAN COHEN
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Credential |
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Telephone | 216-245-4181
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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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