Organization
PROFESSIONAL IMAGING CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE ST. JOHN (CONTRACTING & CREDENTIALING)
(631) 930-5215
Entity
Organization
Contact information
Practice address
3614 VICTORIA AVE, MOUNT VERNON, IL 62864-2208
(618) 315-6058
Mailing address
500 W MAIN ST, SUITE 108, BABYLON, NY 11702-3027
(631) 930-5215
(631) 517-8007
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
03/15/2013
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