MEDICARE: Z HEALTHY IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1023551280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	Z HEALTHY IMAGING LLC

Provider Business Mailing Address
First Line	:	2105 AVENUE U
Second Line	:	STE A
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3609
Country	:	US
Telephone Number	:	718-891-0025
Fax Number	:	718-891-0027

Provider Business Practice Location Address
First Line	:	2105 AVENUE U
Second Line	:	STE A
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3609
Country	:	US
Telephone Number	:	718-891-0025
Fax Number	:	718-891-0027

Authorized Official
Title or Position	:	DIRECTOR
Name	:	OLGA PETROVSKAYA
Credential	:
Telephone Number	:	718-891-0025

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	11/21/2016

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