Provider Demographics
NPI:1710368576
Name:BARNERT IMAGING LLC
Entity type:Organization
Organization Name:BARNERT IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAIRAMACHANDRA
Authorized Official - Middle Name:RAO
Authorized Official - Last Name:KOLLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:848-206-9363
Mailing Address - Street 1:680 BROADWAY
Mailing Address - Street 2:SUITE 005B
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514
Mailing Address - Country:US
Mailing Address - Phone:848-206-6393
Mailing Address - Fax:848-208-7212
Practice Address - Street 1:680 BROADWAY
Practice Address - Street 2:SUITE 008
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514
Practice Address - Country:US
Practice Address - Phone:973-689-7179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology