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General NPI Number Information
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NPI Number | 1306243951
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Entity Type | Organization
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Legal Business Name | 101 IMAGING LLC
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 10601 101ST AVE
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City | OZONE PARK
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State | NY
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Zip | 11416-2712
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Country | US
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Telephone | 718-805-2244
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Fax | 718-844-4510
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Provider Business Mailing Address
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Address Line | 10601 101ST AVE
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City | OZONE PARK
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State | NY
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Zip | 11416-2712
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Country | US
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Telephone | 718-805-2244
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Fax | 718-844-4510
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANITA G SOOKRAJ
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Credential |
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Telephone | 718-805-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number | 41465722
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License Number State | NY
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