Organization
BURLINGTON DIAGNOSTIC IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NAZISH N KHAN (CEO)
(215) 990-9336
Entity
Organization
Contact information
Practice address
2800 ROUTE 130 N STE 202, CINNAMINSON, NJ 08077-3035
(215) 990-9336
Mailing address
2800 ROUTE 130 N # UITE202, CINNAMINSON, NJ 08077-3035
(215) 990-9336
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QR0206X
Mammography Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0450556535
DEPARTMENT OF TREASURY DIVISION OF REVENUE STATE OF NEW JERSEY
NJ
Enumeration date
01/05/2021
Last updated
01/05/2021
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