Healthcare Provider Details
I. General information
NPI: 1760602908
Provider Name (Legal Business Name): ON SITE IMAGING INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2007
Last Update Date: 10/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 KRAFT DRIVE
DEERFIELD NY
13502
US
IV. Provider business mailing address
14 KRAFT DRIVE
DEERFIELD NY
13502
US
V. Phone/Fax
- Phone: 315-733-8393
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471V0106X |
| Taxonomy | Vascular-Interventional Technology Radiologic Technologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471S1302X |
| Taxonomy | Sonography Radiologic Technologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471C1101X |
| Taxonomy | Cardiovascular-Interventional Technology Radiologic Technologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246XS1301X |
| Taxonomy | Sonography Specialist/Technologist Cardiovascular |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471C3402X |
| Taxonomy | Radiography Radiologic Technologist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471V0105X |
| Taxonomy | Vascular Sonography Radiologic Technologist |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 247100000X |
| Taxonomy | Radiologic Technologist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SALVATORE
F.
NICOLETTE
Title or Position: OWNER
Credential:
Phone: 315-733-8393