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NPI Code Detail

MEDICARE: IMAGING & INTERVENTIONAL ASSOCIATE PC

MEDICARE: IMAGING & INTERVENTIONAL ASSOCIATE 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
12085R0204XVascular & Interventional Radiology Physician

General Provider Information

NPI Number : 1578220661
Entity Type Code : Organization
Provider Name (Legal Business Name) : IMAGING & INTERVENTIONAL ASSOCIATE PC
Provider Business Mailing Address
First Line : 4545 CENTER BLVD APT 2413
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11109-5950
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4545 CENTER BLVD APT 2413
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11109-5950
Country : US
Telephone Number : 917-336-8422
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : MEHTAB ABBASI
Credential :
Telephone Number : 917-336-8422
Provider Enumeration Date : 11/23/2021
Last Update Date : 11/23/2021

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Directions to “IMAGING & INTERVENTIONAL ASSOCIATE PC ” Practice Location

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