PROGRESSIVE DIAGNOSTIC IMAGING, LLC (NPI# 1134354210) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134354210 |
| Entity Type | Organization |
| Organization Name | PROGRESSIVE DIAGNOSTIC IMAGING, LLC |
| Other Organization Name | PROGRESSIVE DIAGNOSTIC IMAGING |
| Practice Address |
44 Route 23 North Suite 16 Riverdale NJ 07457 |
| Practice Telephone | 9738395004 |
| Practice Fax Number | 9738395006 |
| Mailing Telephone | 9738395004 |
| Mailing Fax Number | 9738395006 |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |
| Authorized Official Name | MR. MARCUS SPATIDOL (PRINCIPAL/PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 9738395004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
24086 | NJ | Allopathic & Osteopathic Physicians |
| Y | 261Q00000X | Clinic/Center | 24086 | NJ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0163945 | 05 | |
| NJ | STATE LICENSE NUMBER | 24086 | 01 |
| Other Name | Type Code |
|---|---|
| Progressive Diagnostic Imaging | Doing Business As Name - Organization |
| Street Address |
44 ROUTE 23 NORTH SUITE 16 |
| City | RIVERDALE |
| State | NJ |
| Zip Code | 07457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922182161 | Emile Bertrand Gurstelle | Psychologist | 44 Route 23 North, Suite 3, Riverdale, NJ 07457-0003 | 2006-10-24 |
| 1669741666 | Lauren Dietz | Physician Assistant | 44 Route 23 North, Suite 213, Riverdale, NJ 07457 | 2011-12-20 |
| 1275732034 | Open Mri of Warren Lllc | Clinic/Center | 44 Route 23 North, Suite 100, Riverdale, NJ 07457 | 2007-07-12 |
| 1548338957 | Charles Leighton | Social Worker | 44 Route 23 North, Suite 3, Riverdale, NJ 07457-0003 | 2006-12-01 |
| 1316016629 | Jeffrey Weiss Md Pa | Allergy & Immunology | 44 Route 23 North, Suite #6, Riverdale, NJ 07457 | 2006-11-08 |
| 1073698049 | Bharat Dasani | Internal Medicine | 44 Route 23 North, Suite 7, Riverdale, NJ 07457 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395612 | Stephanie D Vortman | Pharmacist | 48 State Route 23, Pharmacy At Walmart, Riverdale, NJ 07457 | 2020-10-30 |
| 1174130918 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Route 23 N, Riverdale, NJ 07457 | 2020-09-25 |
| 1649811589 | Laboratory Medicine Diagnostics | Clinical Medical Laboratory | 82 Newark-pompton Tpke, 2nd Floor, Suite 1, Riverdale, NJ 07457 | 2019-10-02 |
| 1962989632 | Alyson Escalona | Optometrist | 92 Nj-23, Riverdale, NJ 07457 | 2018-07-25 |
| 1235522301 | Heather Diane Weglinski | Registered Nurse | 2214 Ramapo Ct., Riverdale, NJ 07457 | 2015-03-12 |
| 1972923506 | Isaak Gorelov | Rehabilitation Practitioner | 6 North Corporate Drive, Push To Walk, Riverdale, NJ 07457 | 2014-04-22 |
| 1518275346 | Jessie Yenyi Lee | Physical Therapist | 49 Hamburg Turnpike, Riverdale, NJ 07457 | 2010-09-14 |
| 1700054236 | Randi Marie Johansen | Technician/Technologist | 92 Rte 23n, Suite E, Riverdale, NJ 07457 | 2008-02-19 |
| 1649448655 | Emma Mutz | Technician/Technologist | 92 Rte23n, Suite E, Riverdale, NJ 07457 | 2008-02-12 |
| 1962680595 | Pearle Vision Riverdale/relm Opticians,llc | Technician/Technologist | 92 Route 23n, Riverdale, NJ 07457 | 2008-02-06 |
| Find all providers in zip 07457 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164940672 | Primecare Medical Center | Clinic/Center | 86 Upper Riverdale Rd Sw Ste 201, Riverdale, GA 30274-2614 | 2017-09-05 |
| 1659774644 | Rediclinic of Md, LLC | Clinic/Center | 6130 Baltimore Avenue, Riverdale, MD 20737-1905 | 2014-10-03 |
| 1588818330 | Neu Life Chiropractic | Clinic/Center | 6511 Church St, Riverdale, GA 30274-2106 | 2008-11-06 |
| 1427175090 | Southside Medical Center, Inc. | Clinic/Center | 116 Upper Riverdale Rd Sw, Riverdale, GA 30274 | 2007-03-26 |
| 1629159066 | Clayton W Straughn Md Pa | Clinic/Center | 4404 Queensbury Rd Ste 130, Riverdale, MD 20737-1068 | 2006-10-18 |
| 1013497171 | Lotus Family Wellness Clinic, LLC | Clinic/Center | 1240 Highway 138 Sw, Riverdale, GA 30296-1402 | 2018-08-17 |
| 1073028536 | Okeh Health Group, LLC | Clinic/Center | 33 Upper Riverdale Rd Sw, 17, Riverdale, GA 30274 | 2017-12-06 |
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| 1194354407 | Recover Physical Therapy | Clinic/Center | 1501 Old Black Horse Pike Apt F9, Blackwood, NJ 08012-4927 | 2020-04-07 |
| 1154950657 | Real House Inc. | Clinic/Center | 1089-91 East Jersey Street, Elizabeth, NJ 07201 | 2020-04-06 |
| 1205464823 | Fulcrum Performance Lab, LLC | Clinic/Center | 75 S Maple Ave, Marlton, NJ 08053-2032 | 2020-03-30 |
| 1215563887 | Dr Cloyd's Clinical Psychology and Neuropsychology Practice Pllc | Clinic/Center | 1209 Route 70 W, Cherry Hill, NJ 08002-3532 | 2020-03-16 |
| 1144860271 | Sentarus Healthcare Solutions Inc | Clinic/Center | 736 S White Horse Pike, Audubon, NJ 08106-1346 | 2020-01-07 |
| 1497303044 | Sanni Ojibara Training Academy | Clinic/Center | 104 Hillside Ter, Irvington, NJ 07111-1514 | 2019-08-27 |
| 1457907404 | Vitality Wellness Group LLC | Clinic/Center | 1000 Sanger Ave Ste 211, Oceanport, NJ 07757-1241 | 2019-08-15 |
| 1760034292 | Optimally Nourished LLC | Clinic/Center | 303 Belmont Ave Ste 2, Belleville, NJ 07109-1103 | 2019-07-15 |
| 1881246676 | Acenda, Inc. | Clinic/Center | 1129 Route 9 S, Cape May Court House, NJ 08210-2752 | 2019-07-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.