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
-
Sariana Enid Almonte, PA-C
-
Paul E Brody, MD
-
Sydney Coscia, RPA-C
-
Diana Elish, M.D.
-
Inessa Kramerman, PA-C
-
Liliya Besedina, M.D.
-
Olivia Julia Karczewski, PA-C
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Neuroimaging (Radiology) Physician |
2085D0003X | 194192 | NY | |
| Diagnostic Radiology Physician |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1937728 | Medicaid | NY |
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All providers in Jackson Heights, NY · Diagnostic Radiology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.