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General NPI Number Information
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NPI Number | 1891099362
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Entity Type | Organization
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Legal Business Name | COLUMBUS IMAGING CENTER LLC
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Dates
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Enumeration Date | 12/27/2010
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Last Update Date | 05/06/2011
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Provider Practice Location Address
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Address Line | 481-495 NORTH 13TH STREET
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City | NEWARK
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State | NJ
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Zip | 07107-1317
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Country | US
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Telephone | 201-481-7770
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Fax | 201-481-7755
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Provider Business Mailing Address
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Address Line | 481-495 NORTH 13TH STREET
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City | NEWARK
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State | NJ
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Zip | 07107-1317
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Country | US
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Telephone | 201-481-7770
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Fax | 201-481-7755
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. REUVEN ALON
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Credential |
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Telephone | 201-481-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | 24404
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 24404
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License Number State | NJ
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