Organization
PENN DIAGNOSTIC CO.
Active
Organization
PENN DIAGNOSTIC CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MARTIN (OWNER)
(267) 258-6889
Entity
Organization
Contact information
Practice address
2014 NORTH 3RD ST, PHILADELPHIA, PA 19122
(267) 258-6889
Mailing address
9925 BUSTLETON AVE UNIT 14528, PHILADELPHIA, PA 19115-5916
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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