Provider Demographics
NPI:1659484467
Name:AN OPEN MRI IMAGING OF NEWARK, LLC
Entity type:Organization
Organization Name:AN OPEN MRI IMAGING OF NEWARK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-687-6054
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:CLOSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07624-0112
Mailing Address - Country:US
Mailing Address - Phone:732-205-1777
Mailing Address - Fax:201-564-7305
Practice Address - Street 1:243 CHESTNUT ST.
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-6501
Practice Address - Country:US
Practice Address - Phone:732-205-1777
Practice Address - Fax:201-564-7305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0115649Medicaid
104964Medicare PIN
NJ0115649Medicaid