Organization
OPEN MRI OF FAIRVIEW
Active
Other names
Superior Medical Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
LISA A GAGLIANO RT CXT (ADMINISTRATOR)
(201) 941-7575
Entity
Organization
Contact information
Practice address
178 BERGEN BLVD, FAIRVIEW, NJ 07022
(201) 941-7575
(201) 941-1660
Mailing address
178 BERGEN BLVD, PO BOX 99, FAIRVIEW, NJ 07022
(201) 941-7575
(201) 941-1660
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
22693
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8000603
—
NJ
Enumeration date
07/14/2006
Last updated
08/22/2020
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