Advanced Diagnostic Imaging PLLC

Organization Active NPI Diagnostic Radiology Physician · Jackson Heights, NY

NPI 1295008688 · NPPES record last updated Feb 15, 2012

Key facts

NPI
1295008688
Entity type
Organization (NPI type 2)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
194192 (NY)
Legal business name
ADVANCED DIAGNOSTIC IMAGING PLLC
Practice address
90-20 Elmhurst Avenue
Jackson Heights, NY 11372-7936
Phone
(516) 732-0621
NPI assigned
Feb 15, 2012
Organization subpart
No

Authorized official

Name
Sasan Azar, MD
Title
President/Owner
Phone
(516) 732-0621

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Neuroimaging (Radiology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2085D0003X 194192 NY
Diagnostic Radiology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2085R0202X 194192 NY Yes

Addresses

Primary practice location

90-20 Elmhurst Avenue
Jackson Heights, NY 11372-7936

Mailing address

4 Tideway St
Great Neck, NY 11024-1119
Phone (516) 732-0621

Other identifiers

IdentifierTypeStateIssuer
1937728MedicaidNY

Other providers in Jackson Heights, NY

All providers in Jackson Heights, NY · Diagnostic Radiology Physician in New York

Sources for this page

Verify at the official NPI Registry.