Provider Demographics
NPI:1275848921
Name:PROFESSIONAL DIAGNOSTIC SERVICES LLC
Entity Type:Organization
Organization Name:PROFESSIONAL DIAGNOSTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICIER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUSCITTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-366-4945
Mailing Address - Street 1:4380 MALSBARY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5644
Mailing Address - Country:US
Mailing Address - Phone:513-366-4481
Mailing Address - Fax:513-366-4480
Practice Address - Street 1:9870 REDHILL DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5627
Practice Address - Country:US
Practice Address - Phone:513-745-5000
Practice Address - Fax:513-791-7800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CHRIST HOSPITAL CARDIOVASCULAR ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty