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General NPI Number Information
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NPI Number | 1891882585
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Entity Type | Organization
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Legal Business Name | CLEAR VIEW MRI
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2160 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-1855
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Country | US
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Telephone | 516-222-2125
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Fax | 516-222-2126
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Provider Business Mailing Address
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Address Line | 2160 HEMPSTEAD TPKE
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City | EAST MEADOW
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State | NY
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Zip | 11554-1855
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Country | US
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Telephone | 516-222-2125
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Fax | 516-222-2126
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Authorized Official
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Title or Position | CEO
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Name | MR. NICOLA A DIAZ I
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Credential |
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Telephone | 516-222-2125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 179224-1
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License Number State | NY
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