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Organization

MILLBURN MEDICAL IMAGING, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH NESHIBAL (AUTHORIZED OFFICIAL)
(973) 912-0404
Entity
Organization

Contact information

Practice address
2130 MILLBURN AVENUE, MAPLEWOOD, NJ 07040
(973) 912-0404
(973) 912-0444
Mailing address
2130 MILLBURN AVENUE, MAPLEWOOD, NJ 07040
(973) 912-0404
(973) 912-0444

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
22950
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3443809
NJ
Enumeration date
05/23/2006
Last updated
05/01/2008
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