Summit Imaging Corporation

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

License

56016688 Issued in NY

Legal business name

SUMMIT IMAGING CORPORATION

Practice address

15 Ashley PL
Queensbury, NY 12804-2503

Phone

(518) 798-0886

Fax

(518) 743-1560

NPI assigned

Nov 2, 2005

Organization subpart

No

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

Authorized official

Name

Michael Bonan, R.T.R.

Title

President

Phone

(518) 798-0886

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279843200000",
    "number": "1598756181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ASHLEY PL",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042503",
            "telephone_number": "518-798-0886",
            "fax_number": "518-743-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ASHLEY PL",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128042503",
            "telephone_number": "518-798-0886",
            "fax_number": "518-743-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT IMAGING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-02",
        "last_updated": "2010-07-23",
        "status": "A",
        "authorized_official_last_name": "BONAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-798-0886",
        "authorized_official_credential": "R.T.R."
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NY",
            "license": "56016688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01800788",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.