MARINE PARK RADIOLOGY PC NPI 1639217425

NPI Information

NPI: 1639217425
Provider Name: MARINE PARK RADIOLOGY PC

Doing Business As: BROOKLYN MEDICAL IMAGING CENTER

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
450 AVENUE P
BROOKLYN, NY
ZIP 11223
Phone: (718) 375-6000
Get Directions

MARINE PARK RADIOLOGY PC is a diagnostic radiology radiology in Brooklyn, NY. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MARINE PARK RADIOLOGY PC NPI is 1639217425. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Brooklyn Medical Imaging Center.

The provider's business location address is:

450 AVENUE P
BROOKLYN, NY
ZIP 11223-902
Phone: (718) 375-6000
Fax: (718) 375-6576

The provider's authorized official is Alfredo C. Roque .
The authorized official title is Medical Director and has the following contact phone number (718) 375-6000.

The CLIA number assigned to this NPI record is 33D1103619 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 5/6/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W9L411	MEDICARE PIN	NEW YORK
2	02358643	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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