Organization
DIAGNOSIS CENTER OF EXCELLENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAFIK FAKHOURI TECHNICIAN (CHIEF EXECUTIVE OFFICER)
(201) 424-4847
Entity
Organization
Contact information
Practice address
575 LIBERTY AVE, JERSEY CITY, NJ 07307-3910
(201) 424-4847
(201) 656-6366
Mailing address
5005 BERGENLINE AVE, WEST NEW YORK, NJ 07093-5563
(201) 864-2200
(201) 864-9758
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA54305
NJ
Other
Enumeration date
09/16/2009
Last updated
10/23/2009
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