Organization
DISTINGUISHED DIAGNOSTIC IMAGING P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOEL REISMAN (ADMINISTRATOR)
(718) 828-6800
Entity
Organization
Contact information
Practice address
1484 WILLIAMSBRIDGE RD, BRONX, NY 10461-2505
(718) 828-6800
Mailing address
1484 WILLIAMSBRIDGE RD, BRONX, NY 10461-2505
(718) 828-6800
(718) 228-6115
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
50009328
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00901271
—
NY
Enumeration date
04/17/2007
Last updated
11/13/2008
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