Healthcare Provider Details

I. General information

NPI: 1679674253
Provider Name (Legal Business Name): BROOKLYN DIAGNOSTIC IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 KINGS HWY
BROOKLYN NY
11229-1705
US

IV. Provider business mailing address

2525 KINGS HWY
BROOKLYN NY
11229-1705
US

V. Phone/Fax

Practice location:
  • Phone: 718-704-4580
  • Fax: 718-692-8527
Mailing address:
  • Phone: 718-692-5392
  • Fax: 718-692-8527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID M ROSENTHAL
Title or Position: OWNER
Credential: MD
Phone: 917-406-5740