Healthcare Provider Details

I. General information

NPI: 1700340502
Provider Name (Legal Business Name): PINNACLE DMX IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8395 OSWEGO RD
BALDWINSVILLE NY
13027-6801
US

IV. Provider business mailing address

333 METRO PARK STE M207
ROCHESTER NY
14623-2632
US

V. Phone/Fax

Practice location:
  • Phone: 315-303-0088
  • Fax:
Mailing address:
  • Phone: 585-739-3881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY RAGUSA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 585-749-8300