Healthcare Provider Details
I. General information
NPI: 1720209489
Provider Name (Legal Business Name): ALPHA IMAGING CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2007
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
145 E 32ND ST
NEW YORK NY
10016-6055
US
IV. Provider business mailing address
145 E 32ND ST
NEW YORK NY
10016-6055
US
V. Phone/Fax
- Phone: 212-868-9210
- Fax: 212-868-9213
- Phone: 212-868-9210
- Fax: 212-868-9213
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085D0003X |
| Taxonomy | Diagnostic Neuroimaging (Radiology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KARL
L
HUSSMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 212-868-9210