Provider Demographics
NPI:1790112035
Name:JERSEY ADVANCED MRI AND DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:JERSEY ADVANCED MRI AND DIAGNOSTIC CENTER
Other - Org Name:JERSEY ADVANCED MRI AND DIAGNOSTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDUR
Authorized Official - Middle Name:
Authorized Official - Last Name:REHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-552-9464
Mailing Address - Street 1:2127 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-2018
Mailing Address - Country:US
Mailing Address - Phone:201-552-9464
Mailing Address - Fax:201-552-9467
Practice Address - Street 1:2127 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-2018
Practice Address - Country:US
Practice Address - Phone:201-552-9464
Practice Address - Fax:201-552-9467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-01
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ24767261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)