Provider Demographics
NPI:1558599241
Name:IMAGING CENTER OF ORADELL, LLC
Entity Type:Organization
Organization Name:IMAGING CENTER OF ORADELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIARDINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-741-8000
Mailing Address - Street 1:690 KINDERKAMACK RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1524
Mailing Address - Country:US
Mailing Address - Phone:201-262-3000
Mailing Address - Fax:
Practice Address - Street 1:680 KINDERKAMACK RD
Practice Address - Street 2:SUITE # 101
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1600
Practice Address - Country:US
Practice Address - Phone:201-741-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-01
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPENDING261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology