Ridgewood Medical Diagnostic PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

185071 Issued in NY

Legal business name

RIDGEWOOD MEDICAL DIAGNOSTIC PC

Practice address

5629 Metropolitan Ave
Ridgewood, NY 11385-1200

Phone

(718) 648-5858

Fax

(718) 375-2735

NPI assigned

Feb 22, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ian Prescott, MD

Title

Owner

Phone

(718) 648-5858

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329868800000",
    "number": "1326311358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5629 METROPOLITAN AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851200",
            "telephone_number": "718-648-5858",
            "fax_number": "718-375-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5629 METROPOLITAN AVE",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113851200",
            "telephone_number": "718-648-5858",
            "fax_number": "718-375-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD MEDICAL DIAGNOSTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-648-5858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "185071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ridgewood Bushwick Nephrology Associates,PLLC
• Ridgewood Chemists Inc
• Ridgewood City Pharmacy Inc.
• Ridgewood Dental Group
• Ridgewood Dialysis Center, Inc
• Ridgewood Optical Warehouse Outlet Corp.
• Ridgewood Optical, Inc.
• Ridgewood Pharmacy Express Inc
• Ridgewood Volunteer Ambulance Corps Inc
• Ridgewoods Obstetrics & Gynecology

• Family Medicine Physician in Ridgewood, NY
• Providers in Ridgewood, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.