Provider Demographics
NPI:1205680543
Name:AJ DIAGNOSTIC IMAGING
Entity type:Organization
Organization Name:AJ DIAGNOSTIC IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-250-7757
Mailing Address - Street 1:PO BOX 464
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-0464
Mailing Address - Country:US
Mailing Address - Phone:516-250-7757
Mailing Address - Fax:
Practice Address - Street 1:49 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3801
Practice Address - Country:US
Practice Address - Phone:516-250-7757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier