Provider Demographics
NPI:1255589388
Name:ORTHOPAEDIC & NEURO IMAGING LLC
Entity type:Organization
Organization Name:ORTHOPAEDIC & NEURO IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:PFARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-644-7335
Mailing Address - Street 1:26744 JOHN J WILLIAMS HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26744 JOHN J WILLIAMS HIGHWAY
Practice Address - Street 2:SUITE 2
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966
Practice Address - Country:US
Practice Address - Phone:302-644-7335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000016103Medicaid
DCG556OtherBLUE SHIELD
MDKEU80ROtherBLUE SHIELD