Provider Demographics
NPI:1114700010
Name:HACKENSACK MERIDIAN IMAGING FROM ROAD
Entity Type:Organization
Organization Name:HACKENSACK MERIDIAN IMAGING FROM ROAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-481-8529
Mailing Address - Street 1:60 2ND ST FL 4
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2050
Mailing Address - Country:US
Mailing Address - Phone:201-468-4134
Mailing Address - Fax:
Practice Address - Street 1:650 FROM RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3517
Practice Address - Country:US
Practice Address - Phone:201-972-8955
Practice Address - Fax:201-972-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology