Provider Demographics
NPI:1154354850
Name:DIAGNOSTIC IMAGING OF MILFORD, PC
Entity type:Organization
Organization Name:DIAGNOSTIC IMAGING OF MILFORD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-878-2341
Mailing Address - Street 1:30 COMMERCE PARK
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3551
Mailing Address - Country:US
Mailing Address - Phone:203-878-2341
Mailing Address - Fax:203-878-3429
Practice Address - Street 1:30 COMMERCE PARK
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3551
Practice Address - Country:US
Practice Address - Phone:203-878-2341
Practice Address - Fax:203-878-3429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC2501Medicare ID - Type Unspecified