Provider Demographics
NPI:1992050892
Name:POCONO MRI IMAGING AND DIAGNOSTIC CENTER,LLC
Entity type:Organization
Organization Name:POCONO MRI IMAGING AND DIAGNOSTIC CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BHAVNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHABRIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-517-7393
Mailing Address - Street 1:3 PARKINSONS RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-8087
Mailing Address - Country:US
Mailing Address - Phone:570-424-8000
Mailing Address - Fax:570-517-5100
Practice Address - Street 1:239 E BROWN ST
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3005
Practice Address - Country:US
Practice Address - Phone:570-421-3872
Practice Address - Fax:570-421-0842
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:POCONO MRI IMAGING AND DIAGNOSTIC CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-17
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory