Organization
CLIFTON MRI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLEKSANDR WASHINGTON (MANAGER)
(973) 852-3690
Entity
Organization
Contact information
Practice address
750 CLIFTON AVE, CLIFTON, NJ 07013
(973) 852-3690
(973) 852-3696
Mailing address
750 CLIFTON AVE, CLIFTON, NJ 07013-1837
(973) 852-3690
(973) 852-3696
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0607410
—
NJ
01
—
25091
NJ AMBULATORY CARE FACILITY LICENSE
NJ
Enumeration date
01/08/2018
Last updated
04/10/2024
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