Iron Clad Medical Diagnostic P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

IRON CLAD MEDICAL DIAGNOSTIC P.C.

Practice address

3075 Veterans Memorial Hwy
Suite 161
Ronkonkoma, NY 11779-7667

Phone

(631) 648-8860

Fax

(631) 676-7597

NPI assigned

Jun 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Richard Denise

Title

M.D.

Phone

(631) 648-8860

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1467715284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117790094",
            "telephone_number": "631-648-8860",
            "fax_number": "631-676-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 VETERANS MEMORIAL HWY",
            "address_2": "SUITE 161",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797667",
            "telephone_number": "631-648-8860",
            "fax_number": "631-676-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRON CLAD MEDICAL DIAGNOSTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-18",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "DENISE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "631-648-8860",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Ronkonkoma, NY
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• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.