PROVIDENCE DIAGNOSTIC IMAGING, INC.; NPI #1609978170

Contact Information

PROVIDENCE DIAGNOSTIC IMAGING, INC.

271 CAREW ST
SPRINGFIELD, MA 01104-2377

Phone: 413-748-9200
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Diagnostic Radiology	2085R0202X	30	Physician/Diagnostic Radiology
Body Imaging	2085B0100X
Diagnostic Ultrasound	2085U0001X
Neuroradiology	2085N0700X
Nuclear Radiology	2085N0904X
Vascular & Interventional Radiology	2085R0204X	94	Physician/Interventional Radiology

Indicates primary specialty

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NPI Profile & details for PROVIDENCE DIAGNOSTIC IMAGING, INC.

NPI Number 1609978170

LBN Legal business name PROVIDENCE DIAGNOSTIC IMAGING, INC.

Authorized official GREGORY BLACKMAN - (PRESIDENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/03/2006

Last updated 07/01/2015 - About 11 years ago

Identifiers

CT	Medicaid	003126358
MA	Medicaid	9776559
	Other	774327	CONNECTICARE
	Other	1601748	EVERCARE
	Other	CA7920	RAILROAD MEDICARE
	Other	102940700	US DEPARTMENT OF LABOR
MA	Other	783230	AETNA/US HEALTHCARE
MA	Other	M16237	BLUE CROSS/BLUE SHIELD
MA	Other	000000025268	BMC HEALTHNET PLAN
MA	Other	98133101	NETWORK HEALTH
MA	Other	755228	TUFTS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PROVIDENCE DIAGNOSTIC IMAGING, INC.

Contact Information

Specialty

Diagnostic Radiology

Body Imaging

Diagnostic Ultrasound

Neuroradiology

Nuclear Radiology

Vascular & Interventional Radiology

NPI Profile & details for PROVIDENCE DIAGNOSTIC IMAGING, INC.

Reviews for PROVIDENCE DIAGNOSTIC IMAGING, INC.