Organization
ATLANTIC OPEN MRI, LLC
Active
Other names
Atlantic Diagnostics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS T GIBBENS M.D. (MEDICAL DIRECTOR)
(732) 530-8989
Entity
Organization
Contact information
Practice address
766 SHREWSBURY AVE, TINTON FALLS, NJ 07724-3001
(732) 530-8989
(732) 530-0420
Mailing address
766 SHREWSBURY AVE, TINTON FALLS, NJ 07724-3001
(732) 530-8989
(732) 530-0420
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
22368
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1130240V
NJ HORIZON MERCY PIN#
NJ
01
—
1839680
UNITEDHEALTHCARE PIN#
NJ
01
—
2098369000
AMERIHEALTH PIN#
NJ
01
—
28090922
AETNA PIN#
NJ
01
—
2K6430
HEALTHNET PIN#
NJ
01
—
4103497
GHI PIN#
NJ
05
—
8211302
—
NJ
01
—
A959624
OXFORD PIN#
NJ
Enumeration date
12/29/2006
Last updated
02/28/2008
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