Healthcare Provider Details

I. General information

NPI: 1720542137
Provider Name (Legal Business Name): PRIORITY INTERVENTIONAL RADIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8787 N SCOTTSDALE RD STE 105
SCOTTSDALE AZ
85253-2338
US

IV. Provider business mailing address

9343 E BAHIA DR STE 104
SCOTTSDALE AZ
85260-1559
US

V. Phone/Fax

Practice location:
  • Phone: 623-223-8409
  • Fax: 480-534-4061
Mailing address:
  • Phone: 480-795-6722
  • Fax: 480-534-4061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DINO PRATO
Title or Position: CEO
Credential:
Phone: 623-223-8409