Organization Active NPI

Engelwood Diagnostic & Imaging Center LLC

  • Radiology Clinic/Center
  • Englewood, NJ
National Provider Identifier
1164967956
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
24402 Issued in NJ
Legal business name
ENGELWOOD DIAGNOSTIC & IMAGING CENTER LLC
Practice address
177 N Dean St
Suite 202
Englewood, NJ 07631-2533
Phone
(201) 731-3507
Fax
(800) 394-6163
NPI assigned
Jan 3, 2017
Last updated
Aug 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sonia Lasmin
Title
Director
Phone
(201) 874-9084

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X 24402 NJ
Radiology Clinic/Center 261QR0200X 24402 NJ Primary

Addresses

Primary practice location

177 N Dean St
Suite 202
Englewood, NJ 07631-2533

Mailing address

177 N Dean St
Suite 202
Englewood, NJ 07631-2533
Phone (201) 731-3507

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1164967956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 202",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-731-3507",
            "fax_number": "201-731-3056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 N DEAN ST",
            "address_2": "SUITE 202",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312533",
            "telephone_number": "201-731-3507",
            "fax_number": "800-394-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGELWOOD DIAGNOSTIC & IMAGING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "LASMIN",
        "authorized_official_first_name": "SONIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-874-9084"
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": "NJ",
            "license": "24402",
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NJ",
            "license": "24402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.