Basic Information
| Provider Information | |||||||||
| NPI: | 1922188309 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARGATE DIAGNOSTIC CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9710 VENTNOR AVE | ||||||||
| Address2: | |||||||||
| City: | MARGATE CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084022223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098224800 | ||||||||
| FaxNumber: | 6098222617 | ||||||||
| Practice Location | |||||||||
| Address1: | 9710 VENTNOR AVE | ||||||||
| Address2: | |||||||||
| City: | MARGATE CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084022223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098224800 | ||||||||
| FaxNumber: | 6098222617 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CHRISTIAN | ||||||||
| AuthorizedOfficialFirstName: | ANNA | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | ASSISTANT MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6098224800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | X | Laboratories | Clinical Medical Laboratory | 2085R0202X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.