Provider Demographics
NPI:1972701894
Name:APW IMAGING SERVICES, LLC
Entity Type:Organization
Organization Name:APW IMAGING SERVICES, LLC
Other - Org Name:I-DONTICS OF MILLBURN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:ULRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-838-0940
Mailing Address - Street 1:532 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:212-838-0940
Mailing Address - Fax:
Practice Address - Street 1:175 MAIN ST
Practice Address - Street 2:
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1121
Practice Address - Country:US
Practice Address - Phone:973-379-2667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2007-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology