Organization
DIAGNOSTIC IMAGING ASSOCIATES LLC
Active
Other names
Diagnostic Imaging Associates
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GUMBARDO MD (MEDICAL DIRECTOR)
(203) 264-7999
Entity
Organization
Contact information
Practice address
1389 WEST MAIN STREET, WATERBURY, CT 06708
(203) 574-1311
Mailing address
385 MAIN ST SOUTH, C/O NVRA UNION SQUARE BUILDING #1, SOUTHBURY, CT 06488
(203) 264-7999
(203) 264-7477
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004068623
—
CT
Enumeration date
07/24/2006
Last updated
10/28/2013
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