Provider Demographics
NPI:1043255284
Name:NYDIC OPEN MRI OF AMERICA-WESTCHESTER, L.L.C.
Entity type:Organization
Organization Name:NYDIC OPEN MRI OF AMERICA-WESTCHESTER, L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-573-8080
Mailing Address - Street 1:100 PARAGON DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1779
Mailing Address - Country:US
Mailing Address - Phone:201-573-8080
Mailing Address - Fax:201-775-4306
Practice Address - Street 1:4 WESTBROOK CORPORATE CTR
Practice Address - Street 2:TOWER 4, SUITE 40
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5752
Practice Address - Country:US
Practice Address - Phone:708-836-1050
Practice Address - Fax:708-836-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5251666OtherAETNA US HEALTHCARE
IL2204858OtherAETNA US HEALTHCARE
IL01621906OtherBCBS OF ILLINOIS
IL5626535002OtherCIGNA HEALTHCARE
IL2204858OtherAETNA US HEALTHCARE
IL5251666OtherAETNA US HEALTHCARE