| Organization Name: | DIAGNOSTIC IMAGING CENTERS OF NEPA, LLC |
| NPI Number: | 1992945935 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORI M BODNAR (DIRECTOR OF BILLING/CONTRACTING) |
| Mailing Address: | 111 Hulst Dr Ste 708 Matamoras |
| State: | PA US |
| Postal Code: | 183362115 |
| Phone Number: | 5704919200 |
| Fax Number: | 5704919201 |
| NPI Enumeration Date: | 03/04/2009 |
| NPI Last Update Date: | 03/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |