Provider Demographics
NPI:1396988515
Name:STAT IMAGING OF ARAMINGO, LLC
Entity type:Organization
Organization Name:STAT IMAGING OF ARAMINGO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:NONE
Authorized Official - Phone:609-992-2553
Mailing Address - Street 1:100 BRICK RD
Mailing Address - Street 2:SUITE #101
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2146
Mailing Address - Country:US
Mailing Address - Phone:856-983-5599
Mailing Address - Fax:856-985-9061
Practice Address - Street 1:3400 ARAMINGO AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4531
Practice Address - Country:US
Practice Address - Phone:856-983-5599
Practice Address - Fax:856-985-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QR0200X261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology