Provider Demographics
NPI:1043534456
Name:NORTH JERSEY ORTHOPAEDIC SPECIALISTS MRI
Entity Type:Organization
Organization Name:NORTH JERSEY ORTHOPAEDIC SPECIALISTS MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-530-1004
Mailing Address - Street 1:730 PALISADE AVE
Mailing Address - Street 2:MRI SUITE
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3144
Mailing Address - Country:US
Mailing Address - Phone:201-692-1550
Mailing Address - Fax:201-692-1660
Practice Address - Street 1:730 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-530-1004
Practice Address - Fax:201-530-0002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH JERSEY ORTHOPAEDIC SPECIALISTS, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-15
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24301261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)