Provider Demographics
NPI:1447384318
Name:DIAGNOSTIC MEDICAL IMAGING OF L.I., P.C.
Entity Type:Organization
Organization Name:DIAGNOSTIC MEDICAL IMAGING OF L.I., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:P
Authorized Official - Last Name:TAVERNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-766-6550
Mailing Address - Street 1:185 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1431
Mailing Address - Country:US
Mailing Address - Phone:516-766-6550
Mailing Address - Fax:516-678-2882
Practice Address - Street 1:185 MERRICK ROAD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1431
Practice Address - Country:US
Practice Address - Phone:516-766-6550
Practice Address - Fax:516-678-2882
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RADIOLOGICAL ASSOCIATES OF LONG ISLAND, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-15
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty