| Organization Name: | PROGRESSIVE MEDICAL IMAGING OF BLOOMFIELD, LLC |
| NPI Number: | 1053497081 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM FARRELL (MANAGING MEMBER) |
| Mailing Address: | 1255 Broad Ave Suite 101 Bloomfield |
| State: | NJ US |
| Postal Code: | 07003 |
| Phone Number: | 9737711140 |
| Fax Number: | 9737711150 |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0200X |
| License Number: | 23455 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |