Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Professional Radiology PC

Organization Diagnostic Radiology Physician · NPI 1619989464

Professional Radiology PC provides Diagnostic Radiology Physician services 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.

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Practice location Address checks out

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