Provider Demographics
NPI:1720235229
Name:UNITED MEDSCAN CORP
Entity Type:Organization
Organization Name:UNITED MEDSCAN CORP
Other - Org Name:MEDSCAN DIAGNOSTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:VIVANA
Authorized Official - Last Name:RESTREPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-712-1919
Mailing Address - Street 1:88 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-4830
Mailing Address - Country:US
Mailing Address - Phone:201-712-1919
Mailing Address - Fax:
Practice Address - Street 1:88 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-4830
Practice Address - Country:US
Practice Address - Phone:201-712-1919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22849261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)