Rockville Pet Imaging PC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

1124741 Issued in NY

Legal business name

ROCKVILLE PET IMAGING PC

Practice address

119 N Park Ave
Suite 101
Rockville Centre, NY 11570-4113

Phone

(516) 255-9555

Fax

(516) 255-9444

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lucille Patricia Taverna, M.D.

Title

Medical Director

Phone

(516) 255-9555

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lucille P. Taverna-Giardina Other name

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1821161811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N PARK AVE",
            "address_2": "SUITE 101",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704113",
            "telephone_number": "516-255-9555",
            "fax_number": "516-255-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N PARK AVE",
            "address_2": "SUITE 101",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115704113",
            "telephone_number": "516-255-9555",
            "fax_number": "516-255-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKVILLE PET IMAGING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "TAVERNA",
        "authorized_official_first_name": "LUCILLE",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "516-255-9555",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "1124741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00380218",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucille P. Taverna-Giardina",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Diagnostic Radiology Physician in Rockville Centre, NY
• Providers in Rockville Centre, 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 Sep 20, 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.