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Organization

PRIME DIAGNOSTIC IMAGING CORP.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHANIE MARIE MOSS (PRESIDENT)
(631) 648-8860
Entity
Organization

Contact information

Practice address
3075 VETERANS MEMORIAL HWY, SUITE 160, RONKONKOMA, NY 11779-7667
(631) 648-8860
(631) 648-8859
Mailing address
3075 VETERANS MEMORIAL HWY, SUITE 160, RONKONKOMA, NY 11779-7667
(631) 648-8860
(631) 648-8859

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
171063
NY

Other

Enumeration date
05/03/2007
Last updated
12/12/2008
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