Provider Demographics
NPI:1437324712
Name:METROPOLITAN DIAGNOSTIC IMAGING, PC
Entity Type:Organization
Organization Name:METROPOLITAN DIAGNOSTIC IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:WINAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-616-5000
Mailing Address - Street 1:600 NORTHERN BLVD
Mailing Address - Street 2:STE. 115
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5200
Mailing Address - Country:US
Mailing Address - Phone:516-482-8220
Mailing Address - Fax:516-482-8221
Practice Address - Street 1:600 NORTHERN BLVD
Practice Address - Street 2:STE. 115
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5200
Practice Address - Country:US
Practice Address - Phone:516-482-8220
Practice Address - Fax:516-482-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty