NPI Code Detail JSON Logo

1023435971 NPI number — MEDICAL DIAGNOSTIC IMAGING PLLC

NPI Number: 1023435971
Health Care Provider/Practitioner: MEDICAL DIAGNOSTIC IMAGING PLLC

Information about “1023435971” NPI (MEDICAL DIAGNOSTIC IMAGING PLLC) exists in 1023435971 in HTML format HTML  |  1023435971 in plain Text format TXT  |  1023435971 in PDF (Portable Document Format) PDF  |  1023435971 in an XML format XML  formats.

NPI Number : 1023435971 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1023435971",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MEDICAL DIAGNOSTIC IMAGING PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "14 RAYMOND AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "POUGHKEEPSIE",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "12603-2312",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "845-471-2848",
    "MailingAddressFaxNumber": "845-471-2919",
    "FirstLinePracticeLocationAddress": "1323 ROUTE 9",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WAPPINGERS FALLS",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "12590-4904",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "845-471-2848",
    "PracticeLocationAddressFaxNumber": "845-471-2919",
    "EnumerationDate": "03/27/2014",
    "LastUpdateDate": "12/20/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WALDMAN",
    "AuthorizedOfficialFirstName": "MICHAEL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "203-818-1165",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "186503",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0200X",
          "TaxonomyName": "Radiology Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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