Provider Demographics
NPI:1962499772
Name:MAGNETIC IMAGING OF MORRIS P.A.
Entity Type:Organization
Organization Name:MAGNETIC IMAGING OF MORRIS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-402-9111
Mailing Address - Street 1:420 BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MTN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046
Mailing Address - Country:US
Mailing Address - Phone:973-402-9111
Mailing Address - Fax:973-402-7620
Practice Address - Street 1:420 BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:MTN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07046
Practice Address - Country:US
Practice Address - Phone:973-402-9111
Practice Address - Fax:973-402-7620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23244261QM1200X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3361306Medicaid
NJS27468Medicare UPIN
NJ3361306Medicaid