# PRIME DIAGNOSTIC IMAGING CORP.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669684734
- **Authorized official:** STEPHANIE MARIE MOSS (PRESIDENT)
- **Authorized official phone:** (631) 648-8860

## Contact information

- **Practice address:** 3075 VETERANS MEMORIAL HWY, SUITE 160, RONKONKOMA, NY 11779-7667
- **Practice address phone:** (631) 648-8860
- **Practice address fax:** (631) 648-8859
- **Mailing address:** 3075 VETERANS MEMORIAL HWY, SUITE 160, RONKONKOMA, NY 11779-7667
- **Mailing address phone:** (631) 648-8860
- **Mailing address fax:** (631) 648-8859

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | 171063 | NY | Yes |

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 12/12/2008