Healthcare Provider Details

I. General information

NPI: 1699724260
Provider Name (Legal Business Name): BROOKLYN RADIOLOGY SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 6TH ST DEPT OF RADIOLOGY
BROOKLYN NY
11215-3609
US

IV. Provider business mailing address

PO BOX 5471 DEPT OF RADIOLOGY
NEW YORK NY
10087-5471
US

V. Phone/Fax

Practice location:
  • Phone: 718-780-5870
  • Fax: 718-780-7719
Mailing address:
  • Phone: 717-625-3999
  • Fax: 717-625-1730

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 TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN GARNER
Title or Position: EXECUTIVE DIRECTOR
Credential: MD
Phone: 718-780-5870