MEDICARE: PA OPEN MRI-HARRISBURG, PC

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
1	207U00000X	Nuclear Medicine Physician	MD032855E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326007766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PA OPEN MRI-HARRISBURG, PC

Provider Business Mailing Address
First Line	:	5400D CHAMBERS HILL RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17111-2505
Country	:	US
Telephone Number	:	717-558-8300
Fax Number	:	717-561-8024

Provider Business Practice Location Address
First Line	:	5400D CHAMBERS HILL RD
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17111-2505
Country	:	US
Telephone Number	:	717-558-8300
Fax Number	:	717-561-8024

Authorized Official
Title or Position	:	DIRECTOR
Name	:	PHILLIP YUSSEN
Credential	:	MD
Telephone Number	:	717-558-8300

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	08/22/2020

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