Provider Demographics
NPI:1366854259
Name:IR IMAGING MEDICAL SERVICE LLC
Entity Type:Organization
Organization Name:IR IMAGING MEDICAL SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RABIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-736-1785
Mailing Address - Street 1:218 AVENUE B
Mailing Address - Street 2:3F
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3145
Mailing Address - Country:US
Mailing Address - Phone:201-736-1785
Mailing Address - Fax:
Practice Address - Street 1:218 AVENUE B
Practice Address - Street 2:3F
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3145
Practice Address - Country:US
Practice Address - Phone:201-736-1785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile