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General NPI Number Information
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NPI Number | 1053773549
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Entity Type | Organization
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Legal Business Name | NORTHEAST VASCULAR IMAGING GROUP INC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 25 BRIDLEWOOD LOOP
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City | REXFORD
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State | NY
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Zip | 12148-1701
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Country | US
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Telephone | 518-698-9700
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Fax | 518-280-4735
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Provider Business Mailing Address
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Address Line | 25 BRIDLEWOOD LOOP
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City | REXFORD
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State | NY
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Zip | 12148-1701
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Country | US
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Telephone | 518-698-9700
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Fax | 518-280-4735
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. TIMOTHY J ZORN
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Credential |
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Telephone | 518-698-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246X00000X
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Taxonomy Name | Cardiovascular Specialist/Technologist
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License Number |
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License Number State |
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