Provider Demographics
NPI:1174574735
Name:IMAGING PARTNERS, LLC
Entity type:Organization
Organization Name:IMAGING PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCO
Authorized Official - Middle Name:
Authorized Official - Last Name:VERGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-756-8911
Mailing Address - Street 1:134 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2507
Mailing Address - Country:US
Mailing Address - Phone:203-573-6200
Mailing Address - Fax:203-574-0548
Practice Address - Street 1:134 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2507
Practice Address - Country:US
Practice Address - Phone:203-573-6200
Practice Address - Fax:203-574-0548
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIAGNOSTIC RADIOLOGY ASSOCIATES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-16
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO004215283Medicaid
CT470000014OtherMEDICARE PTAN