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NPI Code Detail

MEDICARE: PIVOT IMAGING, INC

MEDICARE: PIVOT IMAGING, 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
1174400000XSpecialist

General Provider Information

NPI Number : 1447761382
Entity Type Code : Organization
Provider Name (Legal Business Name) : PIVOT IMAGING, INC
Provider Business Mailing Address
First Line : 2084 E 8TH ST STE 2R
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-4127
Country : US
Telephone Number : 718-513-6492
Fax Number : 347-619-0108
Provider Business Practice Location Address
First Line : 2084 E 8TH ST STE 2R
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-4127
Country : US
Telephone Number : 718-513-6492
Fax Number : 347-619-0108
Authorized Official
Title or Position : OWNER
Name : GEORGE TKEBUCHAVA
Credential :
Telephone Number : 718-513-6492
Provider Enumeration Date : 10/18/2017
Last Update Date : 10/18/2017

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Directions to “PIVOT IMAGING, INC ” Practice Location

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