Healthcare Provider Details
I. General information
NPI: 1427024199
Provider Name (Legal Business Name): COMPREHENSIVE MRI OF NEW YORK, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/23/2006
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1710 VETERANS MEMORIAL HIGHWAY
ISLANDIA NY
11749-1553
US
IV. Provider business mailing address
110 MARCUS DRIVE
MELVILLE NY
11747-4228
US
V. Phone/Fax
- Phone: 631-348-0996
- Fax: 631-348-0997
- Phone: 631-390-1793
- Fax: 631-390-1780
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
J
DIAMOND
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: M.D.
Phone: 631-694-2929