SANCOR MEDICAL ENTERPRISES LLC (SANCOR VASCULAR IMAGING) - NPI NUMBER 1386715787

Summary

Provider Name: SANCOR MEDICAL ENTERPRISES LLC (SANCOR VASCULAR IMAGING)

NPI Number: 1386715787

Clasification: Radiology (2085U0001X)

Specialization: Diagnostic Ultrasound

Address:
3219 E TREMONT AVE
LL2
BRONX, NY
ZIP 10461

Phone Number: (718) 892-6351



Detailed Information

SANCOR MEDICAL ENTERPRISES LLC is a diagnostic ultrasound radiologist in Bronx, NY. The provider is a Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound. The assigned NPI number for this provider is 1386715787 and is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Sancor Vascular Imaging.

The provider's business address is:

3219 E TREMONT AVE
LL2
BRONX, NY
ZIP 10461-751
Phone: (718) 892-6351
Fax: (718) 892-6350

The provider's authorized official is Corey Weiner .
The authorized official title is President and has the following contact phone number (973) 890-0037.

The enumeration date for this NPI number is 11/10/2006 and was last updated on 3/31/2008.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 2085U0001X Radiology Diagnostic Ultrasound No
2 2086S0129X Surgery Vascular Surgery No
3 2085R0204X Radiology Vascular & Interventional Radiology Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 WZYRV1 MEDICARE PIN NY

NPI Record

No. Field Name Field Value
1 NPI 1386715787
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name SANCOR MEDICAL ENTERPRISES LLC
5 Provider Other Organization Name SANCOR VASCULAR IMAGING
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 3219 E TREMONT AVE
8 Provider Second Line Business Practice Location Address LL2
9 Provider Business Practice Location Address City Name BRONX
10 Provider Business Practice Location Address State Name NY
11 Provider Business Practice Location Address Postal Code 104615751
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 7188926351
14 Provider Business Practice Location Address Fax Number 7188926350
15 Provider Enumeration Date 11/10/2006
16 Last Update Date 3/31/2008
17 Authorized Official Last Name WEINER
18 Authorized Official First Name COREY
19 Authorized Official Title or Position PRESIDENT
20 Authorized Official Telephone Number 9738900037
21 Healthcare Provider Taxonomy Code 1 2085U0001X
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 2086S0129X
24 Healthcare Provider Primary Taxonomy Switch 2 N
25 Healthcare Provider Taxonomy Code 3 2085R0204X
26 Healthcare Provider Primary Taxonomy Switch 3 Y
27 Other Provider Identifier 1 WZYRV1
28 Other Provider Identifier Type Code 1 08
29 Other Provider Identifier State 1 NY
30 Is Organization Subpart N
31 Authorized Official Name Prefix Text MR.
32 Healthcare Provider Taxonomy Group 1 193400000X MULTIPLE SINGLE SPECIALTY GROUP
33 Healthcare Provider Taxonomy Group 2 193400000X MULTIPLE SINGLE SPECIALTY GROUP
34 Healthcare Provider Taxonomy Group 3 193400000X MULTIPLE SINGLE SPECIALTY GROUP

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This page was last updated on: 7/15/2014
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