MEDICARE: ADVANCED WOMENS IMAGING LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207KA0200X	Allergy Physician
2	207RP1001X	Pulmonary Disease Physician
3	207RC0000X	Cardiovascular Disease Physician
4	207RS0012X	Sleep Medicine (Internal Medicine) Physician
5	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1164841979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED WOMENS IMAGING LLC

Provider Business Mailing Address
First Line	:	6416 BERGENLINE AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1621
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6416 BERGENLINE AVE
Second Line	:
City	:	WEST NEW YORK
State	:	NJ
Zip	:	07093-1621
Country	:	US
Telephone Number	:	201-472-8291
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SAIFULLA KHALED CHAUDHARY
Credential	:
Telephone Number	:	973-262-2909

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	09/16/2024

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