MEDICARE: NEW YORK RADIOLOGIC CONSULT SERVICES, P.C.

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	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1598799835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW YORK RADIOLOGIC CONSULT SERVICES, P.C.

Provider Business Mailing Address
First Line	:	260 AINSLIE ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-4914
Country	:	US
Telephone Number	:	718-388-1600
Fax Number	:	718-388-1551

Provider Business Practice Location Address
First Line	:	300 GRAHAM AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-4904
Country	:	US
Telephone Number	:	718-388-1600
Fax Number	:	718-388-1551

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AJAX GEORGE
Credential	:	M.D.
Telephone Number	:	718-388-1600

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	06/02/2008

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