MEDICARE: ULTRAPLUS GROUP, INC.

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	247100000X	Radiologic Technologist

General Provider Information

NPI Number	:	1134451883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ULTRAPLUS GROUP, INC.

Provider Business Mailing Address
First Line	:	2756 GERRITSEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2756 GERRITSEN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5915
Country	:	US
Telephone Number	:	718-753-0330
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KRISTINA ATABEGOVA
Credential	:
Telephone Number	:	718-753-0330

Provider Enumeration Date	:	02/05/2010
Last Update Date	:	02/05/2010

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