Provider Demographics
NPI:1760426589
Name:OPEN MRI RADIOLOGY LLC
Entity Type:Organization
Organization Name:OPEN MRI RADIOLOGY LLC
Other - Org Name:IMAGECARE AT WOODBRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:
Authorized Official - Last Name:HINRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-713-4299
Mailing Address - Street 1:57 ROUTE 46 STE 209
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2695
Mailing Address - Country:US
Mailing Address - Phone:908-979-1621
Mailing Address - Fax:
Practice Address - Street 1:530 GREEN ST LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2654
Practice Address - Country:US
Practice Address - Phone:732-326-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23493261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ100682Medicare ID - Type Unspecified