Organization
PROGRESSIVE DIAGNOSTIC IMAGING, LLC
Active
Other names
Progressive Diagnostic Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS SPATIDOL (PRINCIPAL/PRACTICE ADMINISTRATOR)
(973) 839-5004
Entity
Organization
Contact information
Practice address
44 ROUTE 23 NORTH, SUITE 16, RIVERDALE, NJ 07457
(973) 839-5004
(973) 839-5006
Mailing address
44 ROUTE 23 NORTH, SUITE 16, RIVERDALE, NJ 07457
(973) 839-5004
(973) 839-5006
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
24086
NJ
261Q00000X
Clinic/Center
Primary
24086
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163945
—
NJ
01
—
24086
STATE LICENSE NUMBER
NJ
Enumeration date
05/19/2009
Last updated
05/19/2009
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