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General NPI Number Information
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NPI Number | 1578601662
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Entity Type | Organization
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Legal Business Name | MRI ASSOCIATES OF QUEENS, PC
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 11/26/2008
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Provider Practice Location Address
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Address Line | 9237 METROPOLITAN AVE
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City | FOREST HILLS
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State | NY
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Zip | 11375-6623
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Country | US
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Telephone | 718-544-7994
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Fax |
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Provider Business Mailing Address
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Address Line | 9237 METROPOLITAN AVE
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City | FOREST HILLS
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State | NY
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Zip | 11375-6623
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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 | MANAGING DIRECTOR
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Name | VIKI BUBANY
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Credential |
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Telephone | 718-544-7994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 147975-1
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License Number State | NY
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