1205266392 NPI number — STAND-UP MRI OF CHERRY HILL INC.

Table of content: (NPI 1205266392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205266392 NPI number — STAND-UP MRI OF CHERRY HILL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STAND-UP MRI OF CHERRY HILL INC.
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:
UPRIGHT MRI OF CHERRY HILL
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:
1205266392
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 296
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDAR BROOK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08018-0296
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-704-1857
Provider Business Mailing Address Fax Number:
609-704-1859

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
701 ROUTE 38
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08002-2955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-486-9000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/26/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MOREA
Authorized Official First Name:
PAT
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
973-335-5752

Provider Taxonomy Codes

  • Taxonomy code: 2085B0100X , with the licence number:  23487 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0700X , with the licence number: 23487 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0904X , with the licence number: 23487 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 23487 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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