Radiologic Health Services MRI of Smithtown PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

RADIOLOGIC HEALTH SERVICES MRI OF SMITHTOWN PC

Practice address

80 Maple Ave
Smithtown, NY 11787

Phone

(631) 265-5777

Fax

(631) 265-5797

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Edward H Glenn, MDNPI 1922010776

Title

President

Phone

(631) 265-5777

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward H Glenn, MD

  • Diagnostic Radiology Physician
  • Smithtown, NY
  • NPI 1922010776
  NPD (past) Authorized official

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619908100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N BELLE MEAD ROAD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-265-5777",
            "fax_number": "631-265-5797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MAPLE AVE",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-265-5777",
            "fax_number": "631-265-5797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGIC HEALTH SERVICES MRI OF SMITHTOWN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-265-5777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02213674",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katelyn Quiroga
• Rachel Lessard LCSW PC
• Christian Thomas Racine, PH.D.
• Valentina Emilia Radianu, MD
• Retta A Radin, MS, NCC, LMHC
• Radiology Health Services, PC
• Grace Radner, PHYSICAL THERAPIST
• Leon Rafailov, M.D.
• Jean Marie Rafferty, LCSW
• Stephen E Ragiel, P.T.

• Diagnostic Radiology Physician in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Diagnostic Radiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.