Organization
ADVANCED DIAGNOSTIC IMAGING PLLC
Active
Organization
ADVANCED DIAGNOSTIC IMAGING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SASAN AZAR MD (PRESIDENT/OWNER)
(516) 732-0621
Entity
Organization
Contact information
Practice address
90-20 ELMHURST AVENUE, JACKSON HEIGHTS, NY 11372-7936
(516) 732-0621
Mailing address
4 TIDEWAY ST, GREAT NECK, NY 11024-1119
(516) 732-0621
(631) 366-0391
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
194192
NY
2085R0202X
Diagnostic Radiology Physician
Primary
194192
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1937728
—
NY
Enumeration date
02/15/2012
Last updated
02/15/2012
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