Ridgefield Imaging Center Inc.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

22596 Issued in NJ

Legal business name

RIDGEFIELD IMAGING CENTER INC.

Doing business as

Ridgefield

Practice address

669 Broad Ave
Suite 103
Ridgefield, NJ 07657-1637

Phone

(201) 945-3410

Fax

(201) 945-4438

NPI assigned

Aug 31, 2006

Last updated

Nov 5, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bert Lee

Title

President

Phone

(201) 945-3410

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ridgefield Doing business as

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1982716361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 BROAD AVE",
            "address_2": "SUITE 103",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571637",
            "telephone_number": "201-945-3410",
            "fax_number": "201-945-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 BROAD AVE",
            "address_2": "SUITE 103",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076571637",
            "telephone_number": "201-945-3410",
            "fax_number": "201-945-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEFIELD IMAGING CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "BERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-945-3410",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NJ",
            "license": "22596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "22596",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7767501",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ridgefield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph John Portale, DMD
• Rapha Medical Supply Inc.
• Yaima Requejo
• Ridgefield Board of Education
• Ridgefield Board of Education
• Ridgefield Physical Therapy
• Ridgefield Physical Therapy LLC
• Xiomara Antonia Rojas, LMSW
• Yongki Colin Ryu, DC, MS, ICCSP, DGCSS
• Alice Saraydarian, D.M.D.

• Radiology Clinic/Center in Ridgefield, NJ
• Providers in Ridgefield, NJ by specialty
• Radiology Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.