Provider Demographics
NPI:1265638514
Name:BIMC RADIOLOGY
Entity type:Organization
Organization Name:BIMC RADIOLOGY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-830-3200
Mailing Address - Street 1:10 EXCHANGE PL
Mailing Address - Street 2:WSBS-14TH FLOOR
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3918
Mailing Address - Country:US
Mailing Address - Phone:201-830-3200
Mailing Address - Fax:201-200-0838
Practice Address - Street 1:10 UNION SQ E
Practice Address - Street 2:SUITE 3P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:201-830-3200
Practice Address - Fax:201-200-0838
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIMC RADIOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-25
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology