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NPI Code Detail

MEDICARE: NEW YORK PET IMAGING CENTER LLC

MEDICARE: NEW YORK PET IMAGING CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/CenterH98121487078NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11083680003OTHERNYNPI FOR NIRANJAN K MITTAL
21053564781OTHERNYNPI
3A300001707OTHERNYPTAN

General Provider Information

NPI Number : 1053564781
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW YORK PET IMAGING CENTER LLC
Provider Business Mailing Address
First Line : 7404 5TH AVE STE LL
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-2704
Country : US
Telephone Number : 718-439-5111
Fax Number : 866-790-3506
Provider Business Practice Location Address
First Line : 7404 5TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-2704
Country : US
Telephone Number : 718-439-5111
Fax Number : 866-790-3506
Authorized Official
Title or Position : OWNER
Name : DR. NIRANJAN K MITTAL
Credential : MD
Telephone Number : 718-439-5111
Provider Enumeration Date : 10/28/2008
Last Update Date : 02/13/2023

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