Basic Information
| Provider Information | |||||||||
| NPI: | 1942297759 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LONGWOOD MRI SPECIALISTS INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2501 OREGON PIKE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176014890 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172933223 | ||||||||
| FaxNumber: | 7173902455 | ||||||||
| Practice Location | |||||||||
| Address1: | 637 WASHINGTON ST | ||||||||
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| City: | BROOKLINE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024464500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172771614 | ||||||||
| FaxNumber: | 6172771456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2005 | ||||||||
| LastUpdateDate: | 09/13/2007 | ||||||||
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| AuthorizedOfficialLastName: | SCHWARTZ | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | TREASURER | ||||||||
| AuthorizedOfficialTelephone: | 6172271614 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.