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General NPI Number Information
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NPI Number | 1578551941
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Entity Type | Organization
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Legal Business Name | REGIONAL DIAGNOSTICS LLC
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 04/23/2010
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Provider Practice Location Address
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Address Line | 7575 NORTHCLIFF AVE
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City | BROOKLYN
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State | OH
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Zip | 44144-3267
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Country | US
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Telephone | 216-398-5551
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Fax | 216-398-5589
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Provider Business Mailing Address
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Address Line | 4400 RENAISSANCE PKWY
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City | CLEVELAND
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State | OH
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Zip | 44128-5763
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Country | US
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Telephone | 216-464-8484
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Fax | 216-464-2444
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Authorized Official
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Title or Position | MANAGING PRINCIPLE AND MEDICAL DIRE
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Name | DR. MARK ZHUK
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Credential | M.D.
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Telephone | 216-584-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 1069IC
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License Number State | OH
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