COMPREHENSIVE DIAGNOSTIC IMAGING OF WISCONSIN LLC NPI 1255844106

NPI Information

NPI: 1255844106
Provider Name: COMPREHENSIVE DIAGNOSTIC IMAGING OF WISCONSIN, LLC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 52D2148908

Address:
2500 W LAYTON AVE STE 20
MILWAUKEE, WI
ZIP 53221
Phone: (262) 261-9423
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COMPREHENSIVE DIAGNOSTIC IMAGING OF WISCONSIN, LLC is a diagnostic radiology radiology in Milwaukee, WI. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. COMPREHENSIVE DIAGNOSTIC IMAGING OF WISCONSIN, LLC NPI is 1255844106. The provider is registered as an organization entity type.

The provider's business location address is:

2500 W LAYTON AVE STE 20
MILWAUKEE, WI
ZIP 53221-400
Phone: (262) 261-9423
Fax: (414) 539-4185

The provider's authorized official is James Mazzulla .
The authorized official title is Managing Member and has the following contact phone number (414) 281-2100.

The CLIA number assigned to this NPI record is 52D2148908 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2017 and was last updated on 8/5/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261Q00000X	Clinic/Center		No
2	261QM1200X	Clinic/Center	Magnetic Resonance Imaging (MRI)	No
3	261QR0200X	Clinic/Center	Radiology	No
4	261QR0206X	Clinic/Center	Radiology, Mammography	No
5	2085R0202X	Radiology	Diagnostic Radiology	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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