1982650859 NPI number — NYDIC OPEN MRI OF AMERICA-PARAMUS, LLC

Table of content: (NPI 1982650859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982650859 NPI number — NYDIC OPEN MRI OF AMERICA-PARAMUS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NYDIC OPEN MRI OF AMERICA-PARAMUS, LLC
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:
NYDIC-PARAMUS
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:
1982650859
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:
100 PARAGON DR
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MONTVALE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07645-1779
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-573-8080
Provider Business Mailing Address Fax Number:
201-775-4306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 FOREST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARAMUS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07652-5246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-368-1888
Provider Business Practice Location Address Fax Number:
201-368-1442
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BUCHWALTER
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
201-573-8080

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 1091689 . This is a "FIRST HEALTH NETWORK" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K1377 . This is a "HEALTHNET (PHS OF NJ)" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 36489 . This is a "AMERICAID/AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 492805 . This is a "ONE HEALTH PLAN OF NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 594 . This is a "OXFORD-NYMI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: A745473 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: WTB3011 . This is a "WELLCHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1754053 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2249654 . This is a "CIGNA PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5756601 . This is a "AETNA USHC NON-HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 221661 . This is a "MEDFOCUS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 7748205 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 22912 . This is a "UNIVERSITY HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4196898 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: A745473 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2819063 . This is a "AETNA US HEALTHCARE HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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