Provider Demographics
NPI:1013149913
Name:CONCIERGE BREAST IMAGING & RADIOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:CONCIERGE BREAST IMAGING & RADIOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-244-1500
Mailing Address - Street 1:555 PASSAIC AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7475
Mailing Address - Country:US
Mailing Address - Phone:973-244-1500
Mailing Address - Fax:973-244-1510
Practice Address - Street 1:555 PASSAIC AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7475
Practice Address - Country:US
Practice Address - Phone:973-244-1500
Practice Address - Fax:973-244-1510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty