Provider Demographics
NPI:1558667733
Name:ADVANTAGE IMAGING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ADVANTAGE IMAGING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHERIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-943-1812
Mailing Address - Street 1:220 FORBES RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-2705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:220 FORBES RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-2705
Practice Address - Country:US
Practice Address - Phone:617-943-1812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty