MEDICARE: CLEAR DIAGNOSTIC SOLUTIONS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246W00000X	Cardiology Technician

General Provider Information

NPI Number	:	1033498274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR DIAGNOSTIC SOLUTIONS INC

Provider Business Mailing Address
First Line	:	21455 JAMAICA AVE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11428-1733
Country	:	US
Telephone Number	:	718-413-5040
Fax Number	:	949-798-6806

Provider Business Practice Location Address
First Line	:	21455 JAMAICA AVE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11428-1733
Country	:	US
Telephone Number	:	718-413-5040
Fax Number	:	949-798-6806

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JIM MAGINN
Credential	:
Telephone Number	:	718-413-5040

Provider Enumeration Date	:	08/05/2011
Last Update Date	:	11/22/2016

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