Provider Demographics
NPI:1093867202
Name:STAR OPEN MRI, INC
Entity Type:Organization
Organization Name:STAR OPEN MRI, INC
Other - Org Name:ADVANCED RADIOLOGY & CARDIOVASCULAR CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-559-0300
Mailing Address - Street 1:3729 EASTON NAZARETH HWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8344
Mailing Address - Country:US
Mailing Address - Phone:610-559-0300
Mailing Address - Fax:610-559-1324
Practice Address - Street 1:3729 EASTON NAZARETH HWY
Practice Address - Street 2:SUITE 104
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8344
Practice Address - Country:US
Practice Address - Phone:610-559-0300
Practice Address - Fax:610-559-1324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear RadiologyGroup - Multi-Specialty
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAST004838Medicare ID - Type Unspecified