MEDICARE: PRO IMAGING SERVICES, INC

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	:	1891081030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRO IMAGING SERVICES, INC

Provider Business Mailing Address
First Line	:	2108 W 7TH ST
Second Line	:	SUITE D
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3754
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2108 W 7TH ST
Second Line	:	SUITE D
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3754
Country	:	US
Telephone Number	:	347-492-3500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KRISTINA MIRBABAYEVA
Credential	:
Telephone Number	:	347-492-3500

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	06/27/2011

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Directions to “PRO IMAGING SERVICES, INC ” Practice Location

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