Healthcare Provider Details
I. General information
NPI: 1194736199
Provider Name (Legal Business Name): SOUTH SHORE MAGNETIC RESONANCE IMAGING ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/11/2006
Last Update Date: 02/28/2023
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
81 LOUDEN AVE
AMITYVILLE NY
11701-2736
US
IV. Provider business mailing address
81 LOUDEN AVE
AMITYVILLE NY
11701-2736
US
V. Phone/Fax
- Phone: 631-789-7000
- Fax:
- Phone: 631-789-7000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
AMARJIT
SINGH
Title or Position: OWNER
Credential: MD
Phone: 631-789-7225