Provider Demographics
NPI:1033466248
Name:AMERICAN DIAGNOSTIC IMAGING OF NUTLEY
Entity Type:Organization
Organization Name:AMERICAN DIAGNOSTIC IMAGING OF NUTLEY
Other - Org Name:M.R.N.J.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-661-2000
Mailing Address - Street 1:410 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1635
Mailing Address - Country:US
Mailing Address - Phone:973-661-2000
Mailing Address - Fax:973-661-1116
Practice Address - Street 1:410 CENTRE ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1635
Practice Address - Country:US
Practice Address - Phone:973-661-2000
Practice Address - Fax:973-661-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22787261QM1200X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology