Provider Demographics
NPI:1669994224
Name:UNITED DIAGONSTIC IMAGING LLC
Entity type:Organization
Organization Name:UNITED DIAGONSTIC IMAGING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ TECHNICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:RVT, RPVI
Authorized Official - Phone:203-717-2451
Mailing Address - Street 1:25 RAYMOND ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-5279
Mailing Address - Country:US
Mailing Address - Phone:203-717-2451
Mailing Address - Fax:
Practice Address - Street 1:25 RAYMOND ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06092
Practice Address - Country:US
Practice Address - Phone:203-717-2451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
139269OtherARDMS