Provider Demographics
NPI:1558779793
Name:RADIOLOGY AND IMAGING, INC.
Entity Type:Organization
Organization Name:RADIOLOGY AND IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-827-7400
Mailing Address - Street 1:7412 TOWN BROOKE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-6644
Mailing Address - Country:US
Mailing Address - Phone:920-410-1237
Mailing Address - Fax:
Practice Address - Street 1:125 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1114
Practice Address - Country:US
Practice Address - Phone:413-827-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17636243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner AssistantGroup - Multi-Specialty