Provider Demographics
NPI:1871542316
Name:UNIVERSITY STANDING OPEN MRI OF NEW HAVEN, LLC
Entity type:Organization
Organization Name:UNIVERSITY STANDING OPEN MRI OF NEW HAVEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIJULIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-660-6161
Mailing Address - Street 1:216 CROWN ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2705
Mailing Address - Country:US
Mailing Address - Phone:203-776-2220
Mailing Address - Fax:203-776-2201
Practice Address - Street 1:216 CROWN ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2705
Practice Address - Country:US
Practice Address - Phone:203-776-2220
Practice Address - Fax:203-776-2201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)