# PATCHOGUE OPEN MRI, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** mainstreet medical imaging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174610323
- **Authorized official:** MR. ANTHONY DEGRADI (ADMINISTRATOR)
- **Authorized official phone:** (631) 447-2700

## Contact information

- **Practice address:** 475 E MAIN ST, SUITE 100, PATCHOGUE, NY 11772-3121
- **Practice address phone:** (631) 447-2700
- **Mailing address:** 475 E MAIN ST, SUITE 100, PATCHOGUE, NY 11772-3121
- **Mailing address phone:** (631) 447-2700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/09/2006
- **Last updated:** 02/26/2008