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General NPI Number Information
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NPI Number | 1780973248
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Entity Type | Organization
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Legal Business Name | ONN MANAGEMENT LLC
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 04/05/2011
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Provider Practice Location Address
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Address Line | 4334 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10033-2412
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Country | US
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Telephone | 212-927-1717
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Fax | 212-927-5080
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Provider Business Mailing Address
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Address Line | 4334 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10033-2412
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Country | US
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Telephone | 212-927-1717
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Fax | 212-927-5080
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Authorized Official
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Title or Position | PRESIDENT
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Name | LENIN FERMIN
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Credential |
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Telephone | 212-927-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 130208
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License Number State | OK
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