| Organization Name: | MIDATLANTIC DIAGNOSTIC SERVICES PC |
| NPI Number: | 1225239262 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES JOHN DEMARINO (PRES) |
| Mailing Address: | 55 Pine Rd Gibbsboro |
| State: | NJ US |
| Postal Code: | 08026 |
| Phone Number: | 2153345477 |
| Fax Number: | |
| NPI Enumeration Date: | 05/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | DC0006292 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |