Provider Demographics
NPI:1285714717
Name:MEDICAL IMAGING NETWORK INC.
Entity type:Organization
Organization Name:MEDICAL IMAGING NETWORK INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PERSIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLEGGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-726-9006
Mailing Address - Street 1:819 MCKAY CT
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5713
Mailing Address - Country:US
Mailing Address - Phone:330-726-9006
Mailing Address - Fax:330-726-2061
Practice Address - Street 1:819 MCKAY CT
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5713
Practice Address - Country:US
Practice Address - Phone:330-726-9006
Practice Address - Fax:330-726-2061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0509312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2358238Medicaid
9299168Medicare ID - Type UnspecifiedMAMMOVAN
9299169Medicare ID - Type UnspecifiedBREAST CARE CENTER
OH2358238Medicaid
A16021Medicare UPIN