1275577546 NPI number — DELAWARE OPEN MRI RADIOLOGY ASSOCIATES

Table of content: (NPI 1275577546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275577546 NPI number — DELAWARE OPEN MRI RADIOLOGY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DELAWARE OPEN MRI RADIOLOGY ASSOCIATES
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:
DELAWARE OPEN MRI - MIDDLETOWN
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:
1275577546
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 GREENWOOD AVE
Provider Second Line Business Mailing Address:
SUITE 151
Provider Business Mailing Address City Name:
JENKINTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19046-2627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-379-8458
Provider Business Mailing Address Fax Number:
215-379-8461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
374 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19709-1482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-449-2300
Provider Business Practice Location Address Fax Number:
302-449-2409
Provider Enumeration Date:
06/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SANCHEZ
Authorized Official First Name:
VICTORIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING COORDINATOR
Authorized Official Telephone Number:
215-379-8458

Provider Taxonomy Codes

  • Taxonomy code: 2471M1202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com