1679579775 NPI number — DELAWARE OPEN MRI RADIOLOGY ASSOCIATES LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679579775 NPI number — DELAWARE OPEN MRI RADIOLOGY ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DELAWARE OPEN MRI RADIOLOGY ASSOCIATES 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:
AKUMIN
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:
1679579775
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 GREENWOOD AVENUE
Provider Second Line Business Mailing Address:
SUITE 150
Provider Business Mailing Address City Name:
JENKINTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19046
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-663-5910
Provider Business Mailing Address Fax Number:
215-663-2451

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
H 42 OMEGA DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-738-1700
Provider Business Practice Location Address Fax Number:
302-738-0100
Provider Enumeration Date:
06/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
KASSA
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF OPERATIONS
Authorized Official Telephone Number:
904-515-0362

Provider Taxonomy Codes

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

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

  • Identifier: 0000900602 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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