Healthcare Provider Details

I. General information

NPI: 1578907242
Provider Name (Legal Business Name): PDI HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 05/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SPENCER ST
BROOKLYN NY
11205-1891
US

IV. Provider business mailing address

12 SPENCER ST 620
BROOKLYN NY
11205-1891
US

V. Phone/Fax

Practice location:
  • Phone: 718-388-3300
  • Fax:
Mailing address:
  • Phone: 718-388-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MENACHEM TAUBER
Title or Position: COO
Credential:
Phone: 718-388-3300