LIFESCAN DIAGNOSTICS PC NPI 1184079824

NPI Information

NPI: 1184079824
Provider Name: LIFESCAN DIAGNOSTICS PC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 31D2207277

Address:
160 LANZA AVE STE 9
GARFIELD, NJ
ZIP 07026
Phone: (973) 878-3282
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LIFESCAN DIAGNOSTICS PC is a diagnostic radiology radiology in Garfield, NJ. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. LIFESCAN DIAGNOSTICS PC NPI is 1184079824. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

160 LANZA AVE STE 9
GARFIELD, NJ
ZIP 07026-551
Phone: (973) 878-3282
Fax: (973) 878-1773

The provider's authorized official is Frank Mendonez .
The authorized official title is Managing Ceo and has the following contact phone number (908) 688-6088.

The CLIA number assigned to this NPI record is 31D2207277 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2016 and was last updated on 2/20/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology		Yes
2	261QM2500X	Clinic/Center	Medical Specialty		No
3	261QR0200X	Clinic/Center	Radiology	NEW JERSEY	No
4	261QR0200X	Clinic/Center	Radiology		No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	25MA07582500	OTHER	NEW JERSEY	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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