Provider Demographics
NPI:1568173409
Name:ADVANCED DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:ADVANCED DIAGNOSTICS, LLC
Other - Org Name:ADVANCED DIAGNOSTICS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/RADIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:ASHTER
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:414-801-8609
Mailing Address - Street 1:8649 W BROWN DEER RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53224-2114
Mailing Address - Country:US
Mailing Address - Phone:414-801-8609
Mailing Address - Fax:
Practice Address - Street 1:8649 W BROWN DEER RD
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53224-2114
Practice Address - Country:US
Practice Address - Phone:414-801-8609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology