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NPI Code Detail

MEDICARE: NAZARETH IMAGING ASSOCIATES

MEDICARE: NAZARETH IMAGING ASSOCIATES
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 PhysicianPA

General Provider Information

NPI Number : 1417956079
Entity Type Code : Organization
Provider Name (Legal Business Name) : NAZARETH IMAGING ASSOCIATES
Provider Business Mailing Address
First Line : PO BOX 892
Second Line :
City : CONCORDVILLE
State : PA
Zip : 19331-0892
Country : US
Telephone Number : 215-335-7785
Fax Number :
Provider Business Practice Location Address
First Line : 2601 HOLME AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-2007
Country : US
Telephone Number : 215-335-7785
Fax Number :
Authorized Official
Title or Position : HEAD RADIOLOGIST
Name : DR. DONALD OSTRUM
Credential : M.D.
Telephone Number : 215-335-7785
Provider Enumeration Date : 07/17/2005
Last Update Date : 07/21/2022

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Directions to “NAZARETH IMAGING ASSOCIATES ” Practice Location

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