Provider Demographics
NPI:1457300972
Name:REVEAL DIAGNOSTIC IMAGING OF PENNSYLVANIA LLC
Entity Type:Organization
Organization Name:REVEAL DIAGNOSTIC IMAGING OF PENNSYLVANIA LLC
Other - Org Name:DIAGNOSTIC HEALTH READING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MURAT
Authorized Official - Middle Name:
Authorized Official - Last Name:CAGLAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-342-7100
Mailing Address - Street 1:PO BOX 23137
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29925-3137
Mailing Address - Country:US
Mailing Address - Phone:843-342-7100
Mailing Address - Fax:843-342-5898
Practice Address - Street 1:1025 BERKSHIRE BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1227
Practice Address - Country:US
Practice Address - Phone:610-478-8797
Practice Address - Fax:610-478-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232989Medicare PIN