Provider Demographics
NPI:1811288483
Name:INSIGHT MEDICAL DIAGNOSTICS, PC
Entity type:Organization
Organization Name:INSIGHT MEDICAL DIAGNOSTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINODKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAYUDHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-330-6579
Mailing Address - Street 1:135-16 NORTHERN BLVD
Mailing Address - Street 2:STE 1R
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354
Mailing Address - Country:US
Mailing Address - Phone:516-330-6579
Mailing Address - Fax:
Practice Address - Street 1:763 LARKFIELD RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3131
Practice Address - Country:US
Practice Address - Phone:516-330-6579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237906261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology