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General NPI Number Information
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NPI Number | 1407383888
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Entity Type | Organization
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Legal Business Name | ICARE ULTRASOUND IMAGING, LLC
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 05/17/2017
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Provider Practice Location Address
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Address Line | 7 CHAMBER VALLEY ESTS
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City | SPENCERPORT
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State | NY
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Zip | 14559-9301
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Country | US
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Telephone | 585-260-0837
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CHAMBER VALLEY ESTS
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City | SPENCERPORT
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State | NY
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Zip | 14559-9301
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/SONOGRAPHER
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Name | HAMAD GHAZLE
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Credential | EDD, RDMS
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Telephone | 585-260-0837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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