Organization
ULTRASOUND IMAGE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE MAZZAGATTI (OFFICE MANAGER)
(215) 427-0324
Entity
Organization
Contact information
Practice address
2351 E ALLEGHENY AVE, SUITE 1, PHILA, PA 19134-4431
(215) 427-0324
(215) 427-0308
Mailing address
2351 E ALLEGHENY AVE, SUITE 1, PHILA, PA 19134-4431
(215) 427-0324
(215) 427-0308
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
37657
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025755480001
—
PA
Enumeration date
02/08/2011
Last updated
03/09/2017
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