Provider Demographics
NPI:1447275029
Name:OPEN MRI OF ALLENTOWN LLC
Entity type:Organization
Organization Name:OPEN MRI OF ALLENTOWN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GALAZIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-774-0170
Mailing Address - Street 1:1146 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-7938
Mailing Address - Country:US
Mailing Address - Phone:610-774-0170
Mailing Address - Fax:610-774-0173
Practice Address - Street 1:1146 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-7938
Practice Address - Country:US
Practice Address - Phone:610-774-0170
Practice Address - Fax:610-774-0173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACI2747OtherRAILROAD MEDICARE
PA1741347Medicaid
PA1741347Medicaid