Provider Demographics
NPI:1174821953
Name:JERSEY CITY DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:JERSEY CITY DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-533-8264
Mailing Address - Street 1:2300 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1510
Mailing Address - Country:US
Mailing Address - Phone:201-432-2100
Mailing Address - Fax:201-432-1900
Practice Address - Street 1:2300 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1510
Practice Address - Country:US
Practice Address - Phone:201-432-2100
Practice Address - Fax:201-432-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty