Provider Demographics
NPI:1922148006
Name:NEW ENGLAND DIAGNOSTIC IMAGING, INC.
Entity Type:Organization
Organization Name:NEW ENGLAND DIAGNOSTIC IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTEVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-659-0773
Mailing Address - Street 1:62 INDIAN TRCE
Mailing Address - Street 2:SUITE 60
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4551
Mailing Address - Country:US
Mailing Address - Phone:954-659-0773
Mailing Address - Fax:954-659-0776
Practice Address - Street 1:62 INDIAN TRCE
Practice Address - Street 2:SUITE 60
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-4551
Practice Address - Country:US
Practice Address - Phone:954-659-0773
Practice Address - Fax:954-659-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile