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Contact Information

WISTERIA IMAGING INSTITUTE, LLC
2835 WEST CHELTENHAM AVE
SUITE 312
PHILADELPHIA, PA19150
 Phone: 860-262-4489
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
Indicates primary specialty

NPI Profile & details for WISTERIA IMAGING INSTITUTE, LLC

NPI Number 1255113965
LBN Legal business name WISTERIA IMAGING INSTITUTE, LLC
Authorized official ERIC ADDO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/17/2023
Last updated 10/17/2023 - About 3 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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