Prospect Diagnostic Imaging
LBN: Prospect Diagnostic Imaging
Prospect Diagnostic Imaging is an health care organization with primary practice located at 166 Waterbury Road Rte 69, Prospect CT 06712. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Magnetic Resonance Imaging (MRI), Ambulatory Health Care Facilities / Radiology. Ambulatory Health Care Facilities / Radiology is the primary health care specialty.
Prospect Diagnostic Imaging can be contacted via phone (203) 758-7700, or through Gumbardo, Robert via phone (203) 264-7999.
Contact Information
Primary practice address
166 Waterbury Road Rte 69
Prospect CT 06712
Phone: (203) 758-7700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Magnetic Resonance Imaging (MRI) | 261QM1200X | ||
| Ambulatory Health Care Facilities / Radiology | 261QR0200X |
Profile Details
| NPI number | 1154343739 |
|---|---|
| LBN Legal business name | Prospect Diagnostic Imaging |
| DBA Doing business as | |
| Authorized official | Gumbardo, Robert Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Jul 24th, 2006 |
| Last updated | Jun 6th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154343739 | NPPES |
| Connecticut | MEDICAID | 004221363 |
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