| Progressive Diagnostic Imaging | |
|
44 Route 23 North Suite 16 Riverdale NJ 07457 | |
| (973) 839-5004 | |
| (973) 839-5006 |
| Full Name | Progressive Diagnostic Imaging |
|---|---|
| Speciality | Clinic/Center |
| Location | 44 Route 23 North, Riverdale, New Jersey |
| Authorized Official Name and Position | Marcus Spatidol (PRINCIPAL/PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 9738395004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Diagnostic Imaging 44 Route 23 North Suite 16 Riverdale NJ 07457 Ph: (973) 839-5004 | Progressive Diagnostic Imaging 44 Route 23 North Suite 16 Riverdale NJ 07457 Ph: (973) 839-5004 |
| NPI Number | 1134354210 |
|---|---|
| Provider Enumeration Date | 05/19/2009 |
| Last Update Date | 05/19/2009 |
| Medicare PECOS PAC ID | 3375678238 |
|---|---|
| Medicare Enrollment ID | O20100317000296 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134354210 | NPI | - | NPPES |
| 24086 | Other | NJ | STATE LICENSE NUMBER |
| 0163945 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 24086 (New Jersey) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | 24086 (New Jersey) | Secondary |
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