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General NPI Number Information
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NPI Number | 1053564781
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Entity Type | Organization
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Legal Business Name | NEW YORK PET IMAGING CENTER LLC
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Dates
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Enumeration Date | 10/28/2008
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Last Update Date | 02/13/2023
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Provider Practice Location Address
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Address Line | 7404 5TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-2704
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Country | US
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Telephone | 718-439-5111
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Fax | 866-790-3506
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Provider Business Mailing Address
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Address Line | 7404 5TH AVE STE LL
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City | BROOKLYN
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State | NY
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Zip | 11209-2704
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Country | US
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Telephone | 718-439-5111
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Fax | 866-790-3506
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Authorized Official
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Title or Position | OWNER
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Name | DR. NIRANJAN K MITTAL
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Credential | MD
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Telephone | 718-439-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | H98121487078
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License Number State | NY
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