| NPI | 1194956268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD S WAGNER Owner 631-694-2816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2022-07-07 |