Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Professional Radiology PC

Diagnostic Radiology Physician in Port Jefferson, NY · enumerated 2006 · authorized official Edward Glenn, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1619989464

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Registry record

Entity type Organization (Type 2)

Legal business name Professional Radiology PC

Practice address 75 North Country Road, Port Jefferson, NY, 11777

Phone (631) 476-2757

Fax (631) 473-0132

Enumeration date Aug 12, 2006

Last updated in NPPES Aug 22, 2020

Taxonomy & classification

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Edward Glenn

Title President

Phone (631) 476-2757

Other identifiers

Identifier	Type	State	Issuer
00820911	Medicaid	NY	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where is Professional Radiology PC located?

The practice location on file with NPPES is in Port Jefferson, NY.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-08-22. Verify at npiregistry.cms.hhs.gov.

Providers at this address

Browse all →

Port Interventional Radiology PC Diagnostic Radiology Physician · Port Jefferson, NY NPI 1164434924 Jennifer Condlin Family Nurse Practitioner · Portjefferson, NY NPI 1720360340 Kirolos Ibrahim Ophthalmology Physician · Port Jefferson, NY NPI 1700318821 Abdullah Ali Student in an Organized Health Care Education/Training Program · Port Jefferson, NY NPI 1285321687 Farhad Mohammad Amjad Student in an Organized Health Care Education/Training Program · Port Jefferson, NY NPI 1164282455 Manal Syeda Student in an Organized Health Care Education/Training Program · Port Jefferson, NY NPI 1659121135 Omar Al-Gailani Student in an Organized Health Care Education/Training Program · Port Jefferson, NY NPI 1972351336 Muhammad Haseeb Waseem Student in an Organized Health Care Education/Training Program · Port Jefferson, NY NPI 1356136220

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.