Provider Demographics
NPI:1982819827
Name:OPEN MRI OF MORRISTOWN
Entity Type:Organization
Organization Name:OPEN MRI OF MORRISTOWN
Other - Org Name:DBA ALPHA IMAGING OF MORRIS
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:CLYMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-539-3373
Mailing Address - Street 1:130 SPEEDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-2315
Mailing Address - Country:US
Mailing Address - Phone:973-539-3373
Mailing Address - Fax:
Practice Address - Street 1:95 MADISON AVE STE B04
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7328
Practice Address - Country:US
Practice Address - Phone:973-539-3373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23095261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0123498Medicaid
1295772572OtherNPI
NJ076268Medicare ID - Type Unspecified