Organization
PROSPECT DIAGNOSTIC IMAGING
Active
Parent organization
NAUGATUCK VALLEY RADIOLOGICAL ASSOC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NAUGATUCK VALLEY RADIOLOGICAL ASSOC.
Authorized official
DR. ROBERT GUMBARDO MD (MEDICAL DIRECTOR)
(203) 264-7999
Entity
Organization
Contact information
Practice address
166 WATERBURY ROAD, RTE 69, PROSPECT, CT 06712
(203) 758-7700
Mailing address
385 MAIN ST S, UNION SQUARE BLDG #1 C/O NVRA, SOUTHBURY, CT 06488-4240
(203) 264-7999
(203) 264-7477
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004221363
—
CT
Enumeration date
07/24/2006
Last updated
06/06/2013
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