MEDICARE: 21ST CENTURY RADIOLOGY AND IMAGING, PC

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
1	2085R0202X	Diagnostic Radiology Physician	197988	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093721367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	21ST CENTURY RADIOLOGY AND IMAGING, PC

Provider Business Mailing Address
First Line	:	8686 BAY PKWY
Second Line	:	SUITE M3
City	:	BROOKLYN
State	:	NY
Zip	:	11214-5119
Country	:	US
Telephone Number	:	718-333-0022
Fax Number	:	718-333-0054

Provider Business Practice Location Address
First Line	:	8686 BAY PKWY
Second Line	:	SUITE M3
City	:	BROOKLYN
State	:	NY
Zip	:	11214-5119
Country	:	US
Telephone Number	:	718-333-0022
Fax Number	:	718-333-0054

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. YANINA KARLINSKY
Credential	:
Telephone Number	:	718-333-0022

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	08/03/2015

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