Provider Demographics
NPI:1598257412
Name:TRISTATE TESLA IMAGING LLC
Entity Type:Organization
Organization Name:TRISTATE TESLA IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAZINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-866-3244
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-0047
Mailing Address - Country:US
Mailing Address - Phone:302-696-2105
Mailing Address - Fax:
Practice Address - Street 1:1306 S DUPONT HWY
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4404
Practice Address - Country:US
Practice Address - Phone:561-866-3244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty