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General NPI Number Information
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NPI Number | 1902012743
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Entity Type | Organization
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Legal Business Name | ELMONT OPEN MRI & DIAGNOSTICS RADIOLOGY, PC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 510 OLD COUNTRY RD # 524 SUITE 520
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City | PLAINVIEW
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State | NY
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Zip | 11803-4904
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Country | US
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Telephone | 516-495-5200
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Fax | 516-495-5201
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Provider Business Mailing Address
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Address Line | 1390 HEMPSTEAD TPKE
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City | ELMONT
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State | NY
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Zip | 11003-2539
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Country | US
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Telephone | 516-437-3600
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Fax | 516-326-1702
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Authorized Official
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Title or Position | BILLING COLLECTION MANAGER
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Name | TONY YAMRAJ
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Credential |
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Telephone | 516-437-3600
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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 |
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License Number State |
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