Organization
PROTOCOL IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINICK CARUSO (VASCULAR TECHNOLOGIST)
(973) 768-1304
Entity
Organization
Contact information
Practice address
26 BIRCH ST, BLOOMFIELD, NJ 07003-4004
(973) 768-1304
Mailing address
26 BIRCH ST, BLOOMFIELD, NJ 07003-4004
(973) 768-1304
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
247100000X
Radiologic Technologist
Primary
—
—
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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