Detailed Diagnostic Services, Inc.

Primary specialty

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

Legal business name

DETAILED DIAGNOSTIC SERVICES, INC.

Practice address

1715 Hwy 35
Middletown, NJ 07748-1867

Phone

(516) 612-3511

NPI assigned

Mar 1, 2021

Organization subpart

No

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

Authorized official

Name

Kelly Murray

Title

Manager

Phone

(516) 612-3511

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1790379873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 493",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115630493",
            "telephone_number": "516-612-3511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 HWY 35",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077481867",
            "telephone_number": "516-612-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETAILED DIAGNOSTIC SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-612-3511"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Demko, MSN, APRN, FNP-BC
• Tarjani Desai
• Anastasiya Desch
• Marc Ronald Desiderio, D.C.
• Ralph Desiderio, M.S.P.T.
• Developmental Disabilities Association of NJ Inc.
• Wendy Devirgiliis, APN
• Robert Dibona, D.D.S.
• Morrison Diep, PHARMD
• Stephanie Danielle Dipreta, MSOT, OTR/L, ATRIC

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Middletown, NJ
• Providers in Middletown, NJ by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.