# DIAGNOSTIC X-RAY SERVICE INC

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

## Provider details

- **NPI number:** 1750465423
- **Authorized official:** MR. JACOB RUSSELL WUERSTLE (PRESIDENT)
- **Authorized official phone:** (814) 459-6280

## Contact information

- **Practice address:** 2828 MAIN ST, BUFFALO, NY 14214-1722
- **Practice address phone:** (814) 459-6280
- **Mailing address:** 1769 W 26TH ST, ERIE, PA 16508-1256
- **Mailing address phone:** (800) 446-9729
- **Mailing address fax:** (814) 459-6386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 293D00000X | Physiological Laboratory | — | NULL | Yes |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 09/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01676219 | — | NY |
| 05 | — | 02997253 | — | NY |