Provider Demographics
NPI:1922029909
Name:PAVONIA MEDICAL IMAGING INC
Entity Type:Organization
Organization Name:PAVONIA MEDICAL IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMOLO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAURIZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-222-3225
Mailing Address - Street 1:14 MEADOWBROOK COURT
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901
Mailing Address - Country:US
Mailing Address - Phone:201-222-3225
Mailing Address - Fax:201-499-0249
Practice Address - Street 1:600 PAVONIA AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2929
Practice Address - Country:US
Practice Address - Phone:201-222-3225
Practice Address - Fax:201-499-0249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty