Provider Demographics
NPI:1396700266
Name:NORTHSHORE IMAGING SERVICES, PSC
Entity type:Organization
Organization Name:NORTHSHORE IMAGING SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:787-820-1667
Mailing Address - Street 1:PO BOX 141269
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1269
Mailing Address - Country:US
Mailing Address - Phone:787-820-1667
Mailing Address - Fax:787-898-5643
Practice Address - Street 1:270 CARR 2
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-2488
Practice Address - Country:US
Practice Address - Phone:787-820-1667
Practice Address - Fax:787-898-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty