Healthcare Provider Details

I. General information

NPI: 1760860308
Provider Name (Legal Business Name): DIAGNOSTIC MR IMAGING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 05/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 BROADWAY SUITE 1D
NEW YORK NY
10034-1602
US

IV. Provider business mailing address

5000 BROADWAY SUITE 1D
NEW YORK NY
10034-1602
US

V. Phone/Fax

Practice location:
  • Phone: 212-567-5191
  • Fax:
Mailing address:
  • Phone: 212-567-5191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number156503
License Number StateNY

VIII. Authorized Official

Name: DR. JOHN T. RIGNEY
Title or Position: OWNER
Credential:
Phone: 212-567-5191