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General NPI Number Information
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NPI Number | 1720329048
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Entity Type | Organization
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Legal Business Name | JR MEDICAL DIAGNOSTIC PC
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 5 JEANNE DR SUITE 5
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City | NEWBURGH
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State | NY
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Zip | 12550-1798
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Country | US
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Telephone | 845-564-5300
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Fax | 845-564-5301
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Provider Business Mailing Address
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Address Line | 5 JEANNE DR SUITE 5
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City | NEWBURGH
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State | NY
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Zip | 12550-1798
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Country | US
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Telephone | 845-564-5300
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Fax | 845-564-5301
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN THOMAS RIGNEY
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Credential | M.D.
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Telephone | 845-564-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 156503
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License Number State | NY
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