Provider Demographics
NPI:1144767955
Name:COMPREHENSIVE IMAGING AND DIAGNOSTICS
Entity Type:Organization
Organization Name:COMPREHENSIVE IMAGING AND DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-815-7829
Mailing Address - Street 1:3131 PRINCETON PIKE
Mailing Address - Street 2:BLD5 5 SUITE 208
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2201
Mailing Address - Country:US
Mailing Address - Phone:609-815-7829
Mailing Address - Fax:609-815-7829
Practice Address - Street 1:540 WOODBOURNE RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1856
Practice Address - Country:US
Practice Address - Phone:877-244-6266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty