Diagnosis Center of Excellence

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA54305 Issued in NJ

Legal business name

DIAGNOSIS CENTER OF EXCELLENCE

Practice address

575 Liberty Ave
Jersey City, NJ 07307-3910

Phone

(201) 424-4847

Fax

(201) 656-6366

NPI assigned

Sep 16, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Wafik Fakhouri, TECHNICIAN

Title

Chief Executive Officer

Phone

(201) 424-4847

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256256000000",
    "number": "1174856595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 BERGENLINE AVE",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070935563",
            "telephone_number": "201-864-2200",
            "fax_number": "201-864-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 LIBERTY AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073073910",
            "telephone_number": "201-424-4847",
            "fax_number": "201-656-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSIS CENTER OF EXCELLENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-10-23",
        "status": "A",
        "authorized_official_last_name": "FAKHOURI",
        "authorized_official_first_name": "WAFIK",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "201-424-4847",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "TECHNICIAN"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA54305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Jersey City, NJ
• Providers in Jersey City, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2009; 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.