Provider Demographics
NPI:1578787784
Name:ALLWOOD IMAGING, P.A.
Entity Type:Organization
Organization Name:ALLWOOD IMAGING, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:E
Authorized Official - Last Name:YIDI-DOERR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-777-5022
Mailing Address - Street 1:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-0684
Mailing Address - Country:US
Mailing Address - Phone:973-777-5022
Mailing Address - Fax:
Practice Address - Street 1:914 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2708
Practice Address - Country:US
Practice Address - Phone:973-777-5022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty