Provider Demographics
NPI:1346362233
Name:NATIONAL DIAGNOSTIC IMAGING,LLC
Entity Type:Organization
Organization Name:NATIONAL DIAGNOSTIC IMAGING,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-514-1199
Mailing Address - Street 1:25700 SCIENCE PARK
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122
Mailing Address - Country:US
Mailing Address - Phone:216-514-1199
Mailing Address - Fax:216-514-9911
Practice Address - Street 1:25700 SCIENCE PARK
Practice Address - Street 2:SUITE 180
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122
Practice Address - Country:US
Practice Address - Phone:216-514-1199
Practice Address - Fax:216-514-9911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0744912Medicaid
A17298Medicare UPIN
OH0744912Medicaid