Provider Demographics
NPI:1518928506
Name:NORTHAMPTON IMAGING CENTER
Entity Type:Organization
Organization Name:NORTHAMPTON IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SPLAIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-663-3441
Mailing Address - Street 1:421 W CHEW ST
Mailing Address - Street 2:PHYSICIAN ACCOUNTS
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-3406
Mailing Address - Country:US
Mailing Address - Phone:610-663-3441
Mailing Address - Fax:610-663-3170
Practice Address - Street 1:602 E 21ST ST
Practice Address - Street 2:SUITE 401
Practice Address - City:NORTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18067-1259
Practice Address - Country:US
Practice Address - Phone:610-262-6622
Practice Address - Fax:610-262-6432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017514500004Medicaid
PA03161600OtherCBC GROUP NUMBER
20021128OtherAMERIHEALTH MERCY
0040634000OtherIBC
PA475764OtherHIGHMARK BS GROUP NUMBER
CC7763OtherRR MEDICARE #
1520160OtherGATEWAY HEALTH PLAN
PA03161600OtherCBC GROUP NUMBER