Organization
COOLIDGE CORNER IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD B MARIANACCI M.D. (MANAGER)
(617) 383-6585
Entity
Organization
Contact information
Practice address
356 HARVARD ST, BROOKLINE, MA 02446-2905
(617) 383-6585
(617) 383-6592
Mailing address
356 HARVARD ST, BROOKLINE, MA 02446-2905
(617) 383-6585
(617) 383-6592
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9750240
—
MA
Enumeration date
08/12/2010
Last updated
08/23/2010
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