Provider Demographics
NPI:1235187832
Name:COMPREHENSIVE MRI OF NEW YORK, P.C.
Entity Type:Organization
Organization Name:COMPREHENSIVE MRI OF NEW YORK, P.C.
Other - Org Name:CAPITAL REGION UPRIGHT MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIAMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-694-2929
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-0127
Mailing Address - Country:US
Mailing Address - Phone:631-694-2816
Mailing Address - Fax:631-390-1779
Practice Address - Street 1:4 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-5641
Practice Address - Country:US
Practice Address - Phone:518-220-2080
Practice Address - Fax:518-220-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02916461Medicaid
NY02916461Medicaid