MEDICARE: PREFERRED MEDICAL NUCLEAR IMAGING 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

General Provider Information

NPI Number	:	1922392810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED MEDICAL NUCLEAR IMAGING P.C.

Provider Business Mailing Address
First Line	:	PO BOX 5004
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-0252
Country	:	US
Telephone Number	:	718-931-3232
Fax Number	:	718-931-2023

Provider Business Practice Location Address
First Line	:	1111 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-2310
Country	:	US
Telephone Number	:	718-931-3232
Fax Number	:	718-931-2023

Authorized Official
Title or Position	:	DIRECTOR
Name	:	YANA STUDENTOVA
Credential	:	MD
Telephone Number	:	718-931-3232

Provider Enumeration Date	:	06/08/2011
Last Update Date	:	06/08/2011

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