MEDICARE: ADVANCED DIGITAL DIAGNOSTICS, LLC

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	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	H98 1269403 76	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00641071	OTHER	NY	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1154510261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED DIGITAL DIAGNOSTICS, LLC

Provider Business Mailing Address
First Line	:	169 COMMACK RD STE H350
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-3442
Country	:	US
Telephone Number	:	631-838-8309
Fax Number	:	631-910-0333

Provider Business Practice Location Address
First Line	:	11 NEWBROOK LN
Second Line	:
City	:	EAST NORTHPORT
State	:	NY
Zip	:	11731-5230
Country	:	US
Telephone Number	:	631-838-8309
Fax Number	:	631-910-0333

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVEN T ISAACS
Credential	:
Telephone Number	:	631-838-8309

Provider Enumeration Date	:	10/15/2007
Last Update Date	:	05/18/2026

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