Provider Demographics
NPI:1689700403
Name:AZAD K. ANAND, MD, PC
Entity Type:Organization
Organization Name:AZAD K. ANAND, MD, PC
Other - Org Name:LONG ISLAND DIAGNOSTIC IMAGING, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-364-4600
Mailing Address - Street 1:100 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3934
Mailing Address - Country:US
Mailing Address - Phone:516-364-4600
Mailing Address - Fax:516-364-4646
Practice Address - Street 1:23 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4075
Practice Address - Country:US
Practice Address - Phone:631-689-7300
Practice Address - Fax:631-689-7321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY510205472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY51020547OtherDOH CERTIFICATE OF REGIST
NY1902838816OtherINDIVIDUAL NPI
NY120964OtherFDA CERTIFICATION