Healthcare Provider Details

I. General information

NPI: 1194934281
Provider Name (Legal Business Name): PRECISION RADIATION ONCOLOGY SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 55TH ST SUITE G-104
BROOKLYN NY
11220-2559
US

IV. Provider business mailing address

150 55TH ST SUITE G-104
BROOKLYN NY
11220-2559
US

V. Phone/Fax

Practice location:
  • Phone: 718-630-7065
  • Fax:
Mailing address:
  • Phone: 718-630-7065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number202463
License Number StateNY

VIII. Authorized Official

Name: AUDREY SAITTA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-630-7065