Provider Demographics
NPI:1306884309
Name:VALLEY OPEN MRI
Entity type:Organization
Organization Name:VALLEY OPEN MRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MARKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-745-4050
Mailing Address - Street 1:2301 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6130
Mailing Address - Country:US
Mailing Address - Phone:215-938-9674
Mailing Address - Fax:215-947-0212
Practice Address - Street 1:2301 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6130
Practice Address - Country:US
Practice Address - Phone:215-938-9674
Practice Address - Fax:215-947-0212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPAEDIC SURGERY & REHABILITATION ASSOC., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA114005Medicare PIN