WISTERIA IMAGING INSTITUTE, LLC – NPI #1255113965
Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Health Care Provider Taxonomy Code for Radiology

WISTERIA IMAGING INSTITUTE, LLC is a radiologist located in PHILADELPHIA, PA. NPPES has assigned the NPI number 1255113965 to WISTERIA IMAGING INSTITUTE, LLC on October 17, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085R0202X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Diagnostic Radiology

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for WISTERIA IMAGING INSTITUTE, LLC below.

NPI Profile for
WISTERIA IMAGING INSTITUTE, LLC

NPI Number
1255113965
Enumeration Date

(more than 2 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WISTERIA IMAGING INSTITUTE, LLC
Primary location
2835 WEST CHELTENHAM AVE
SUITE 312
PHILADELPHIA, PA 19150
Phone: (860) 262-4489 Fax:
Mailing address
601 APALACHEE DR NE
ST PETERSBURG, FL 33702-2766
Phone: (860) 262-4489 Fax:
Organization Subpart
No
Authorized Official
ERIC ADDO
OWNER
Phone: (860) 262-4489
Updated
Certification Date
Oct 16, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085R0202X
- Radiology / Diagnostic Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.