Provider Demographics
NPI:1043207855
Name:WEST MORRIS IMAGING P.A.
Entity Type:Organization
Organization Name:WEST MORRIS IMAGING P.A.
Other - Org Name:MRI OF WEST MORRIS PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEXLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-927-1010
Mailing Address - Street 1:66 SUNSET STRIP
Mailing Address - Street 2:SUITE 105 MRI OF WEST MORRIS
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876
Mailing Address - Country:US
Mailing Address - Phone:973-927-1010
Mailing Address - Fax:972-927-7273
Practice Address - Street 1:66 SUNSET STRIP
Practice Address - Street 2:SUITE 105 MRI OF WEST MORRIS
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876
Practice Address - Country:US
Practice Address - Phone:973-927-1010
Practice Address - Fax:972-927-7273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23305261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5295301Medicaid
NJ5295301Medicaid