Provider Demographics
NPI:1467873968
Name:QUANTUM IMAGING AND THERAPEUTIC ASSOCIATES, INC.
Entity Type:Organization
Organization Name:QUANTUM IMAGING AND THERAPEUTIC ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERGEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-932-5200
Mailing Address - Street 1:629D LOWTHER RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBERRY
Mailing Address - State:PA
Mailing Address - Zip Code:17339-9527
Mailing Address - Country:US
Mailing Address - Phone:717-932-5200
Mailing Address - Fax:717-932-3095
Practice Address - Street 1:4600 NEW LINDEN HILL RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2953
Practice Address - Country:US
Practice Address - Phone:717-932-5200
Practice Address - Fax:717-932-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-31
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty