Providence Diagnostic Imaging, Inc.
LBN: Providence Diagnostic Imaging, Inc.
Providence Diagnostic Imaging, Inc. is an health care organization with primary practice located at 271 Carew St , Springfield MA 01104-2377. The organization recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Diagnostic Radiology is the primary health care specialty.
Providence Diagnostic Imaging, Inc. can be contacted via phone (413) 748-9200, or through Blackman, Gregory E. via phone (413) 748-9200.
Contact Information
Primary practice address
271 Carew St
Springfield MA 01104-2377
Phone: (413) 748-9200
Fax:
Website:
Authorized official contact:
Name: Blackman, Gregory E. Doctor of Medicine (MD)
Phone: (413) 748-9200
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | ||
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | ||
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | ||
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ||
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ||
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X |
Profile Details
| NPI number | 1609978170 |
|---|---|
| LBN Legal business name | Providence Diagnostic Imaging, Inc. |
| DBA Doing business as | |
| Authorized official | Blackman, Gregory E. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 3rd, 2006 |
| Last updated | Jul 1st, 2015 - about 10 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 | 1609978170 | NPPES |
| Other | 102940700 | US DEPARTMENT OF LABOR | |
| Other | 98133101 | US DEPARTMENT OF LABOR | |
| Other | 000000025268 | US DEPARTMENT OF LABOR | |
| Other | 755228 | US DEPARTMENT OF LABOR | |
| MEDICAID | 003126358 | US DEPARTMENT OF LABOR | |
| Other | 1601748 | US DEPARTMENT OF LABOR | |
| Other | 774327 | US DEPARTMENT OF LABOR | |
| MEDICAID | 9776559 | US DEPARTMENT OF LABOR | |
| Other | CA7920 | US DEPARTMENT OF LABOR | |
| Other | 783230 | US DEPARTMENT OF LABOR | |
| Other | M16237 | US DEPARTMENT OF LABOR |
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