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General NPI Number Information
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NPI Number | 1972960664
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC & IMAGING ASSOCIATES
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Dates
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Enumeration Date | 01/26/2016
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 90 BAR BEACH RD
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-4029
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Country | US
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Telephone | 917-688-2400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1546
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-7546
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REPRESENTATIVE
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Name | MIKE ROBERTS
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Credential |
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Telephone | 917-688-2405
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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