Provider Demographics
NPI:1407806102
Name:TRENTON OSTEOPATHIC RADIOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:TRENTON OSTEOPATHIC RADIOLOGY ASSOCIATES, PC
Other - Org Name:CONTEMPORARY IMAGING DOWNRIVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FINAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:734-362-0900
Mailing Address - Street 1:PO BOX 72287
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44192-0002
Mailing Address - Country:US
Mailing Address - Phone:248-668-3085
Mailing Address - Fax:248-449-7103
Practice Address - Street 1:1676 FORT ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2003
Practice Address - Country:US
Practice Address - Phone:734-362-0900
Practice Address - Fax:734-362-0911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P23200Medicare ID - Type Unspecified