Provider Demographics
NPI:1104704600
Name:NORTH JERSEY MEDICAL IMAGING
Entity type:Organization
Organization Name:NORTH JERSEY MEDICAL IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAHEED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHKBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-936-9947
Mailing Address - Street 1:410 CENTRE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1635
Mailing Address - Country:US
Mailing Address - Phone:973-354-9700
Mailing Address - Fax:800-589-8370
Practice Address - Street 1:410 CENTRE ST STE 1
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-1635
Practice Address - Country:US
Practice Address - Phone:973-354-9700
Practice Address - Fax:800-589-8370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology