Provider Demographics
NPI:1447283080
Name:ADVANCED IMAGING OF ROBINSON, LLC
Entity type:Organization
Organization Name:ADVANCED IMAGING OF ROBINSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIPROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-359-8743
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15230-0060
Mailing Address - Country:US
Mailing Address - Phone:412-937-5726
Mailing Address - Fax:412-937-5706
Practice Address - Street 1:133 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-3269
Practice Address - Country:US
Practice Address - Phone:412-310-2730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102817Medicare PIN