MEDICARE: IMAGING ASSOCIATES, 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	2471N0900X	Nuclear Medicine Technology Radiologic Technologist	44-0016	MA
2	246W00000X	Cardiology Technician
3	246XS1301X	Sonography Specialist/Technologist Cardiovascular
4	2471B0102X	Bone Densitometry Radiologic Technologist
5	2085N0904X	Nuclear Radiology Physician
6	2085U0001X	Diagnostic Ultrasound Physician
7	207UN0901X	Nuclear Cardiology Physician
8	2471S1302X	Sonography Radiologic Technologist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IM 022169	OTHER	MA	MEDICARE PROVIDER NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952324006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAGING ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	270 CENTRE ST
Second Line	:	UNIT B
City	:	HOLBROOK
State	:	MA
Zip	:	02343-1073
Country	:	US
Telephone Number	:	781-767-5111
Fax Number	:	781-767-5191

Provider Business Practice Location Address
First Line	:	270 CENTRE ST
Second Line	:	UNIT B
City	:	HOLBROOK
State	:	MA
Zip	:	02343-1073
Country	:	US
Telephone Number	:	781-767-5111
Fax Number	:	781-767-5191

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM DONOVAN
Credential	:
Telephone Number	:	781-767-5111

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	05/29/2008

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270 CENTRE ST , UNIT B
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