Healthcare Provider Details

I. General information

NPI: 1982939971
Provider Name (Legal Business Name): ON SITE IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 KRAFT DR
DEERFIELD NY
13502-1126
US

IV. Provider business mailing address

PO BOX 29
NEW YORK MILLS NY
13417-0029
US

V. Phone/Fax

Practice location:
  • Phone: 315-733-8393
  • Fax: 315-765-6201
Mailing address:
  • Phone: 315-733-8393
  • Fax: 315-765-6201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number239674
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2471V0106X
TaxonomyVascular-Interventional Technology Radiologic Technologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. SALVATORE F NICOLETTE
Title or Position: PRESIDENT
Credential: LRT
Phone: 315-733-8393