MEDICARE: INNERVIEW IMAGING 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
1	2085B0100X	Body Imaging Physician

General Provider Information

NPI Number	:	1326629072
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNERVIEW IMAGING LLC

Provider Business Mailing Address
First Line	:	32 FREDERICK AVE
Second Line	:
City	:	LAKE GROVE
State	:	NY
Zip	:	11755-3212
Country	:	US
Telephone Number	:	631-766-3531
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 FREDERICK AVE
Second Line	:
City	:	LAKE GROVE
State	:	NY
Zip	:	11755-3212
Country	:	US
Telephone Number	:	631-766-3531
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER SEHY
Credential	:
Telephone Number	:	631-766-3531

Provider Enumeration Date	:	04/15/2021
Last Update Date	:	04/22/2021

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Directions to “INNERVIEW IMAGING LLC ” Practice Location

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