Prospect Medical Imaging P.C.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

157428 Issued in NY

Legal business name

PROSPECT MEDICAL IMAGING P.C.

Practice address

586 Midland Ave
Ste 2C
Staten Island, NY 10306-5903

Phone

(347) 512-1716

NPI assigned

Oct 26, 2016

Last updated

Oct 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Denise Richard, M.D.

Title

President

Phone

(347) 512-1716

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1437601325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "586 MIDLAND AVE",
            "address_2": "STE 2C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065903",
            "telephone_number": "347-512-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "586 MIDLAND AVE",
            "address_2": "STE 2C",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103065903",
            "telephone_number": "347-512-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPECT MEDICAL IMAGING P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "RICHARD",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-512-1716",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "157428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "157428",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Staten Island, NY by specialty
• Health Service Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; 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.