Provider Demographics
NPI:1013952225
Name:NYDIC OPEN MRI OF AMERICA-PENSACOLA
Entity Type:Organization
Organization Name:NYDIC OPEN MRI OF AMERICA-PENSACOLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-573-8080
Mailing Address - Street 1:100 PARAGON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1779
Mailing Address - Country:US
Mailing Address - Phone:201-573-8080
Mailing Address - Fax:201-775-4306
Practice Address - Street 1:5330 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2006
Practice Address - Country:US
Practice Address - Phone:850-484-8666
Practice Address - Fax:850-484-7663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1216008OtherFIRST HEALTH NETWORK
FL59026119OtherBCBS OF ALABAMA
FLMR55114-61OtherSYNERGY INSURANCE SYSTEMS
FL20332OtherMEDFOCUS
FL34-00045OtherUNITED HEALTHCARE OF FL
FL7773831OtherCIGNA HEALTHCARE
FL7855117OtherAETNA US HEALTHCARE
FLV2203OtherBCBS OF FLORIDA
FLMR55114-61OtherSYNERGY INSURANCE SYSTEMS