Provider Demographics
NPI:1396465415
Name:WAYNE RADIOLOGY CENTER CO
Entity type:Organization
Organization Name:WAYNE RADIOLOGY CENTER CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUBERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-955-8888
Mailing Address - Street 1:96 LINWOOD PLZ # 432
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-3701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:516 HAMBURG TPKE STE 6
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2063
Practice Address - Country:US
Practice Address - Phone:973-720-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty