Organization Name: | JANWELLE MEDICAL DIAGNOSTIC SERVICES |
NPI Number: | 1386923498 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSELITO C MALONZO (PRESIDENT) |
Mailing Address: | 121 N 20th St Kenilworth |
State: | NJ US |
Postal Code: | 070331201 |
Phone Number: | 9084564784 |
Fax Number: | 2012578818 |
NPI Enumeration Date: | 08/06/2011 |
NPI Last Update Date: | 08/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0208X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology, Mobile |
Taxonomy Definition: |