Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Professional Radiology PC

Organization Diagnostic Radiology Physician · NPI 1619989464

Professional Radiology PC is a Diagnostic Radiology Physician in Port Jefferson, New York. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

75 N Country Rd
Port Jefferson, NY 11777
Phone: (631) 476-2757
Fax: (631) 473-0132
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X

Record details

NPI number1619989464
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edward Glenn — President · (631) 476-2757
NPI enumeratedAugust 12, 2006
Last updated in NPPESAugust 22, 2020
Mailing address75 North Country Road, Port Jefferson, NY 11777

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