Healthcare Provider Details
I. General information
NPI: 1235485459
Provider Name (Legal Business Name): SAGA IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/25/2012
Last Update Date: 07/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
159 E 74 ST MEZZANINE
NEW YORK NY
10021-3235
US
IV. Provider business mailing address
130 E 77 ST. FL 5
NEW YORK NY
10075-1851
US
V. Phone/Fax
- Phone: 212-737-3301
- Fax: 212-734-0407
- Phone: 212-737-3301
- Fax: 212-734-0407
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1200X |
| Taxonomy | Magnetic Resonance Imaging (MRI) Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHEN
J
NICHOLAS
Title or Position: MEMBER
Credential: MD
Phone: 212-737-3301