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General NPI Number Information
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NPI Number | 1093839847
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Entity Type | Organization
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Legal Business Name | BROOKLYN NUCLEAR SPECT IMAGING
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7515 13TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11228-2409
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Country | US
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Telephone | 718-234-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 7515 13TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11228-2409
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Country | US
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Telephone | 718-234-8111
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROBERT A VACCARINO
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Credential | M.D.
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Telephone | 718-368-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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