Organization
BSI ACQUISITION, LP
Active
Other names
Broad Street Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE CARR (PRESIDENT)
(215) 663-5910
Entity
Organization
Contact information
Practice address
221 N BROAD ST, SUITE 101, PHILADELPHIA, PA 19107-1511
(215) 557-0121
(215) 557-9003
Mailing address
101 GREENWOOD AVE, SUITE 150, JENKINTOWN, PA 19046-2627
(215) 663-5910
(215) 663-2451
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019205900004
—
PA
Enumeration date
04/17/2006
Last updated
08/22/2020
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