Provider Demographics
NPI:1437429305
Name:NORTHSTAR IMAGING
Entity Type:Organization
Organization Name:NORTHSTAR IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHORZEMPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-258-2823
Mailing Address - Street 1:66 DWIGHT RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1889
Mailing Address - Country:US
Mailing Address - Phone:800-620-5205
Mailing Address - Fax:800-620-5205
Practice Address - Street 1:66 DWIGHT RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1889
Practice Address - Country:US
Practice Address - Phone:800-620-5205
Practice Address - Fax:800-620-5205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile