Provider Demographics
NPI:1760513303
Name:MEDI-IMAGING
Entity Type:Organization
Organization Name:MEDI-IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PALMIERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-493-3600
Mailing Address - Street 1:111 MULBERRY ST
Mailing Address - Street 2:SUITE 1R
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-4008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 MULBERRY ST
Practice Address - Street 2:SUITE 1R
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-4008
Practice Address - Country:US
Practice Address - Phone:973-493-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA066725207RC0000X
NJMA0405382085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty