Provider Demographics
NPI:1801823661
Name:WOMENS DIAGNOSTIC CENTER, P.A.
Entity Type:Organization
Organization Name:WOMENS DIAGNOSTIC CENTER, P.A.
Other - Org Name:THE IMAGECARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-361-7350
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 1:89 SPARTA AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1777
Practice Address - Country:US
Practice Address - Phone:973-729-0002
Practice Address - Fax:973-729-1085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ055158Medicare PIN