Provider Demographics
NPI:1154319259
Name:MEDICAL IMAGING NETWORK INC
Entity Type:Organization
Organization Name:MEDICAL IMAGING NETWORK INC
Other - Org Name:ADVANCED RADIOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLEGGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-726-9006
Mailing Address - Street 1:819 MCKAY CT
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5713
Mailing Address - Country:US
Mailing Address - Phone:330-726-9006
Mailing Address - Fax:330-726-2068
Practice Address - Street 1:5500 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2214
Practice Address - Country:US
Practice Address - Phone:330-856-9729
Practice Address - Fax:330-856-4079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2119559Medicaid
OH2119559Medicaid
A16021Medicare UPIN