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NPI Code Detail

MEDICARE: COMPLETE RADIOLOGY, P.C.

MEDICARE: COMPLETE RADIOLOGY, P.C.
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
1261QR0200XRadiology Clinic/Center180577NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14198755OTHERNYGHI

General Provider Information

NPI Number : 1619195963
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPLETE RADIOLOGY, P.C.
Provider Business Mailing Address
First Line : 3852 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-2013
Country : US
Telephone Number : 718-743-2300
Fax Number : 718-769-5512
Provider Business Practice Location Address
First Line : 3852 NOSTRAND AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-2013
Country : US
Telephone Number : 718-743-2300
Fax Number : 718-769-5512
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : ROBERT D. SOLOMON
Credential : M.D.
Telephone Number : 718-743-2300
Provider Enumeration Date : 04/23/2007
Last Update Date : 08/22/2020

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