Suffolk Medical Imaging, PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SUFFOLK MEDICAL IMAGING, PC

Practice address

2780 Middle Country Road
Suite 210
Lake Grove, NY 11755

Phone

(631) 588-4500

Fax

(631) 588-4595

NPI assigned

Aug 25, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Robert Antonacci, MD

Title

President

Phone

(631) 588-4500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1760615793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 MIDDLE COUNTRY ROAD",
            "address_2": "SUITE 210",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "11755",
            "telephone_number": "631-588-4500",
            "fax_number": "631-588-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 MIDDLE COUNTRY ROAD",
            "address_2": "SUITE 210",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "11755",
            "telephone_number": "631-588-4500",
            "fax_number": "631-588-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK MEDICAL IMAGING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "ANTONACCI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-588-4500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Harlan Stetler, MD
• Laura Marie Stonborg
• Marlo Suazo
• Sathish Jay Subbaiah, M.D.
• Suffolk Breast Imaging PC
• Michelle Nicole Tallini, CF-SLP
• Kari Ann Tanury, LPN
• Nicholas Stephen Teodoro, MD
• Teragram II, Inc
• Tabitha Lynn Tirado, LPN

• Diagnostic Radiology Physician in Lake Grove, NY
• Providers in Lake Grove, 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 25, 2009; 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.