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NPI Code Detail

MEDICARE: HIA BENSONHURST IMAGING ASSOCIATES, LLP

MEDICARE: HIA BENSONHURST IMAGING ASSOCIATES, LLP
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/Center

Other Identifiers

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

General Provider Information

NPI Number : 1407833452
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIA BENSONHURST IMAGING ASSOCIATES, LLP
Provider Business Mailing Address
First Line : PO BOX 18005
Second Line :
City : HAUPPAUGE
State : NY
Zip : 11788-8805
Country : US
Telephone Number : 631-517-8000
Fax Number : 631-893-1923
Provider Business Practice Location Address
First Line : 7610 13TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-2412
Country : US
Telephone Number : 718-836-3322
Fax Number : 718-921-2830
Authorized Official
Title or Position : SENIOR PARTNER
Name : DR. ALAN BERLLY
Credential : MD
Telephone Number : 718-836-3322
Provider Enumeration Date : 12/29/2005
Last Update Date : 09/14/2007

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