Organization
BOSTON IMAGING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WENXING FAN M.D. (MANAGER)
(860) 801-0330
Entity
Organization
Contact information
Practice address
65 HARRISON AVE, #506, BOSTON, MA 02111-1924
(860) 801-0330
(860) 415-6388
Mailing address
37 ADELLE DR, DOVER, NH 03820-4457
(860) 801-0330
(860) 415-6388
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
129878
MA
261QR0208X
Mobile Radiology Clinic/Center
129878
MA
Other
Enumeration date
10/09/2014
Last updated
12/08/2014
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