Healthcare Provider Details

I. General information

NPI: 1366770869
Provider Name (Legal Business Name): DIAGNOSTIC MR IMAGING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2009
Last Update Date: 06/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 BROADWAY SUITE 1D
NEW YORK NY
10034
US

IV. Provider business mailing address

5000 BROADWAY SUITE 1D
NEW YORK NY
10034
US

V. Phone/Fax

Practice location:
  • Phone: 212-567-5191
  • Fax: 212-567-5093
Mailing address:
  • Phone: 212-567-5191
  • Fax: 212-567-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

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