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NPI Code Detail

MEDICARE: ADVANCED MEDICAL IMAGING OF NORTH JERSEY, LLC

MEDICARE: ADVANCED MEDICAL IMAGING OF NORTH JERSEY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician23131NJ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4DA3186OTHERNJRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1S75304OTHERNJAIM
22K3550OTHERNJHEALTHNET
3A2945029OTHERNJOXFORD
5S20Y21OTHERNJBLUE CROSS BLUE SHIELD
62173755000OTHERNJAMERIHEALTH

General Provider Information

NPI Number : 1144221771
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED MEDICAL IMAGING OF NORTH JERSEY, LLC
Provider Business Mailing Address
First Line : 452 OLD HOOK RD
Second Line : SUITE 301
City : EMERSON
State : NJ
Zip : 07630-1381
Country : US
Telephone Number : 201-262-0001
Fax Number : 201-262-2330
Provider Business Practice Location Address
First Line : 452 OLD HOOK RD
Second Line : SUITE 301
City : EMERSON
State : NJ
Zip : 07630-1381
Country : US
Telephone Number : 201-262-0001
Fax Number : 201-262-2330
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : MARK L. SHAPIRO
Credential : MD
Telephone Number : 201-262-0001
Provider Enumeration Date : 08/04/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

1922009760 — JOEL D JACOWITZ M.D
Practice Location Address:
452 OLD HOOK RD , 2ND FLOOR
EMERSON, NJ
07630-1381
Practice Phone: 201-666-3900
Practice Fax: 201-261-0505
1730160870 — IRA I ZUCKER M.D.
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Practice Fax: 201-261-0505
1366419145 — SYLVA A. TAKVORIAN M.D.
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452 OLD HOOK RD FL 2
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07630-1381
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Practice Fax: 201-261-0505
1669441929 — STEVEN M ROSNER M.D.
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EMERSON, NJ
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1831168194 — EDWARD J GOLD M.D.
Practice Location Address:
452 OLD HOOK RD , 2ND FLOOR
EMERSON, NJ
07630-1381
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1437113107 — FRANCO DIAZ MD
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