Healthcare Provider Details

I. General information

NPI: 1659664001
Provider Name (Legal Business Name): NEXRAY MEDICAL IMAGING, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2011
Last Update Date: 05/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1963 GRAND CONCOURSE SUITE B
BRONX NY
10453-4994
US

IV. Provider business mailing address

1963 GRAND CONCOURSE SUITE B
BRONX NY
10453-4994
US

V. Phone/Fax

Practice location:
  • Phone: 718-901-0002
  • Fax: 718-901-0009
Mailing address:
  • Phone: 718-901-0002
  • Fax: 718-901-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number179573-2
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number179573-2
License Number StateNY

VIII. Authorized Official

Name: DR. WILLIAM ALAN WEINER
Title or Position: MEDICAL DIRECTOR
Credential: D.O.
Phone: 718-901-0002