Provider Demographics
NPI:1851444913
Name:ALLIANCE DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:ALLIANCE DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIPANJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DECHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-735-3678
Mailing Address - Street 1:1661 E FLAMINGO RD STE 5A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5291
Mailing Address - Country:US
Mailing Address - Phone:702-735-3678
Mailing Address - Fax:702-735-1491
Practice Address - Street 1:1661 E FLAMINGO RD STE 5A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5291
Practice Address - Country:US
Practice Address - Phone:702-735-3678
Practice Address - Fax:702-735-1491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========OtherEIN