Provider Demographics
NPI:1184864795
Name:PROGRESSIVE X-RAY OF KEARNY, LLC
Entity Type:Organization
Organization Name:PROGRESSIVE X-RAY OF KEARNY, LLC
Other - Org Name:PROGRESSIVE X-RAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PIROVANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-541-5401
Mailing Address - Street 1:401 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-2703
Mailing Address - Country:US
Mailing Address - Phone:201-541-5401
Mailing Address - Fax:201-816-1724
Practice Address - Street 1:816 KEARNY AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-3148
Practice Address - Country:US
Practice Address - Phone:201-316-3295
Practice Address - Fax:201-933-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology