Provider Demographics
NPI:1861581654
Name:MAGNETIC RESONANCE IMAGING OF HUNTINGTON, P.C.
Entity type:Organization
Organization Name:MAGNETIC RESONANCE IMAGING OF HUNTINGTON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-666-5620
Mailing Address - Street 1:214 WALL ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2064
Mailing Address - Country:US
Mailing Address - Phone:631-666-5620
Mailing Address - Fax:631-666-4668
Practice Address - Street 1:214 WALL ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2064
Practice Address - Country:US
Practice Address - Phone:631-666-5620
Practice Address - Fax:631-666-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00984941Medicaid