Provider Demographics
NPI:1467589507
Name:ULTRASOUND IMAGING SERVICES, INC
Entity Type:Organization
Organization Name:ULTRASOUND IMAGING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TAUTIVA
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS
Authorized Official - Phone:781-834-3888
Mailing Address - Street 1:414 PLAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-2719
Mailing Address - Country:US
Mailing Address - Phone:781-834-3888
Mailing Address - Fax:781-834-3888
Practice Address - Street 1:60 PARK ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5224
Practice Address - Country:US
Practice Address - Phone:508-771-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37159246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3755396OtherAETNA
MAAA24533OtherHARVARD PILGRIM HEALTH
MA80314OtherUNICARE
MA039469OtherBLUE CROSS BLUE SHIELD
MA039469OtherBLUE CROSS BLUE SHIELD