Provider Demographics
NPI:1952667438
Name:PRECISION DIAGNOSTIC IMAGING INC
Entity Type:Organization
Organization Name:PRECISION DIAGNOSTIC IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:631-561-1686
Mailing Address - Street 1:1650 SYCAMORE AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-1731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1650 SYCAMORE AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-1731
Practice Address - Country:US
Practice Address - Phone:631-561-1686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty