Healthcare Provider Details

I. General information

NPI: 1215864442
Provider Name (Legal Business Name): CR MEDICAL IMAGING PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E 60TH ST LOWER LEVEL
NEW YORK NY
10022-1694
US

IV. Provider business mailing address

110 E 60TH ST LOWER LEVEL
NEW YORK NY
10022-1694
US

V. Phone/Fax

Practice location:
  • Phone: 212-363-7315
  • Fax: 212-363-7316
Mailing address:
  • Phone: 212-363-7315
  • Fax: 212-363-7316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FABIOLA ELEZI
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 212-363-7315