| Organization Name: | BREAST HEALTH CENTER OF RIDGEWOOD, PC |
| NPI Number: | 1326251158 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HAROLD M BRUCK (PRESIDENT) |
| Mailing Address: | 385 S Maple Ave Glen Rock |
| State: | NJ US |
| Postal Code: | 074521543 |
| Phone Number: | 2016704550 |
| Fax Number: | 2016706318 |
| NPI Enumeration Date: | 05/08/2007 |
| NPI Last Update Date: | 09/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0206X |
| License Number: | 104380 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mammography |
| Taxonomy Definition: | |