Provider Demographics
NPI:1346477346
Name:PROFESSIONAL DIAGNOSTIC INC.
Entity Type:Organization
Organization Name:PROFESSIONAL DIAGNOSTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V/P
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-854-3366
Mailing Address - Street 1:4300 N UNIVERSITY DR
Mailing Address - Street 2:B-203
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6249
Mailing Address - Country:US
Mailing Address - Phone:954-854-3366
Mailing Address - Fax:954-622-9135
Practice Address - Street 1:4300 N UNIVERSITY DR
Practice Address - Street 2:B-203
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6249
Practice Address - Country:US
Practice Address - Phone:954-854-3366
Practice Address - Fax:954-622-9135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty