Provider Demographics
NPI:1902144595
Name:SAINT BARNABAS OUTPATIENT CENTERS
Entity Type:Organization
Organization Name:SAINT BARNABAS OUTPATIENT CENTERS
Other - Org Name:DIAGNOSTIC IMAGING OF NORTHFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AVP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-322-7331
Mailing Address - Street 1:772 NORTHFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1100
Mailing Address - Country:US
Mailing Address - Phone:585-241-6851
Mailing Address - Fax:973-325-8140
Practice Address - Street 1:772 NORTHFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1100
Practice Address - Country:US
Practice Address - Phone:973-789-9950
Practice Address - Fax:973-325-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography