Provider Demographics
NPI:1063871846
Name:KNOPF RADIOLOGY AND HEALTH SERVICES
Entity type:Organization
Organization Name:KNOPF RADIOLOGY AND HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZUDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:OGOGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-470-5627
Mailing Address - Street 1:634 E CHESTER PIKE
Mailing Address - Street 2:APT F 1
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-1731
Mailing Address - Country:US
Mailing Address - Phone:484-470-5627
Mailing Address - Fax:
Practice Address - Street 1:634 E,CHESTER PIKE
Practice Address - Street 2:APT F 1
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078
Practice Address - Country:US
Practice Address - Phone:484-470-5627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6352517261QR0208X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile