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PROFESSIONAL RADIOLOGY PC
NPI 1619989464
Radiology - Diagnostic Radiology in Port Jefferson, NY

Active since August 12, 2006
75 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777(631) 476-2757(631) 473-0132 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Professional Radiology Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROFESSIONAL RADIOLOGY PC (NPI 1619989464) is a healthcare organization registered as a diagnostic radiology in Port Jefferson, New York and active in the NPI registry since August 2006. The organization lists Edward H Glenn, President, as its authorized official.

NPPES Registry Identity

NPI1619989464
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NamePROFESSIONAL RADIOLOGY PC
Location Address75 NORTH COUNTRY ROADPort Jefferson, NY 11777
Mailing Address75 North Country RoadPort Jefferson, NY 11777 · (631) 476-2757 · Fax (631) 473-0132
Phone(631) 476-2757
Fax(631) 473-0132
Organization SubpartNo
Authorized OfficialEdward H GlennPresident · (631) 476-2757
Enumeration DateAugust 12, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1619989464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
75 NORTH COUNTRY ROAD, Port Jefferson, NY 11777
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Other Identifiers 1

Medicaid00820911NY

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FARHAD MOHAMMAD AMJAD
Student in an Organized Health Care Education/Training Program
75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
PORT INTERVENTIONAL RADIOLOGY PC
Radiology (Diagnostic Radiology)
75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
Suffolk County (631) 476-2757
ABDULLAH ALI M.D.
Student in an Organized Health Care Education/Training Program
75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
Suffolk County (631) 473-1320
MUHAMMAD HASEEB WASEEM M.D
Student in an Organized Health Care Education/Training Program
75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
CAREENA ANN LOBO
Student in an Organized Health Care Education/Training Program
75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
Suffolk County (631) 476-2874
MANAL SYEDA DO
Student in an Organized Health Care Education/Training Program
75 NORTH COUNTRY ROAD
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
DR. KIROLOS IBRAHIM M.D.
Ophthalmology
75 NORTH COUNTRY ROAD, MATHER HOSPITAL GME
PORT JEFFERSON, NY 11777
Suffolk County (631) 686-2549
JENNIFER DAWN CONDLIN RN
Nurse Practitioner (Family)
75 NORTH COUNTRY ROAD
PORTJEFFERSON, NY 11777
Suffolk County (631) 473-1320

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Professional Radiology PC's NPI number?

The NPI number for Professional Radiology PC is 1619989464. It was assigned to this organization in the NPPES registry on August 12, 2006.

Where is Professional Radiology PC located?

Professional Radiology PC is located at 75 North Country Road, Port Jefferson, NY 11777. The listed phone number is (631) 476-2757.

What is Professional Radiology PC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Professional Radiology PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.