1164536827 NPI number — NATIONAL IMAGING P.C.

Table of content: (NPI 1164536827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164536827 NPI number — NATIONAL IMAGING P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATIONAL IMAGING P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NATIONAL MEDICAL IMAGING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164536827
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 768
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10018-0025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-360-2233
Provider Business Mailing Address Fax Number:
410-360-2234

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1903 S BROAD ST # 05
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19148-2216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-463-1825
Provider Business Practice Location Address Fax Number:
215-463-1828
Provider Enumeration Date:
08/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROSENBERG
Authorized Official First Name:
MAURY
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
215-564-2800

Provider Taxonomy Codes

  • Taxonomy code: 2085B0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085N0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0904X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085U0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10228101 . This is a "AMERIGROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0327002000 . This is a "INDEPENDANCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100731142000 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 095176 . This is a "BCBS PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1097153 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com