DISTINGUISHED DIAGNOSTIC IMAGING P.C. NPI 1306061890

NPI Information

NPI: 1306061890
Provider Name: DISTINGUISHED DIAGNOSTIC IMAGING P.C.
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 33D2113968

Address:
1484 WILLIAMSBRIDGE RD
BRONX, NY
ZIP 10461
Phone: (718) 828-6800
Get Directions

DISTINGUISHED DIAGNOSTIC IMAGING P.C. is a multi-specialty clinic center in Bronx, NY. DISTINGUISHED DIAGNOSTIC IMAGING P.C. NPI is 1306061890. The provider is registered as an organization entity type.

The provider's business location address is:

1484 WILLIAMSBRIDGE RD
BRONX, NY
ZIP 10461-505
Phone: (718) 828-6800

The provider's authorized official is Joel Reisman .
The authorized official title is Administrator and has the following contact phone number (718) 828-6800.

The CLIA number assigned to this NPI record is 33D2113968 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/17/2007 and was last updated on 11/13/2008.

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	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	50009328	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00901271	MEDICAID	NEW YORK
2	W39251	MEDICARE PIN	NEW YORK

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: 11/14/2023

NPI Synchronization or Removal

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