Psi Radiological Service Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

24834 Issued in MI

Legal business name

PSI RADIOLOGICAL SERVICE INC

Practice address

1320 Wilkins St
Detroit, MI 48207-4802

Phone

(313) 656-2151

Fax

(313) 656-2152

NPI assigned

Apr 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Victor Collado, M.D., PH.D

Title

Radiologist

Phone

(313) 656-2151

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1972726156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264324",
            "telephone_number": "313-962-2133",
            "fax_number": "313-962-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WILKINS ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074802",
            "telephone_number": "313-656-2151",
            "fax_number": "313-656-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSI RADIOLOGICAL SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "COLLADO",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "RADIOLOGIST",
        "authorized_official_telephone_number": "313-656-2151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "24834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114483540",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR GOLDSMITH",
            "identifier": "JG006327",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR MAY",
            "identifier": "AM010635",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Prysak, MD, MPH
• Michael F Prysak, MD
• Sean M. Prystash, M.D.
• Melissa Ann Przywara, OTR
• Psi Radiological Service Inc
• Psi Radiological Service, Inc
• Psi Radiologist Group, PC
• Demetrious K Psimoulis, M.D.
• Psych MD PLLC
• Psychiatry and Behavioral Medicine Professionals (University Psychiatric Centers)

• Diagnostic Radiology Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.