Provider Demographics
NPI:1043406820
Name:M.G.K.S.C.Z. MAGNETIC RESONANCE IMAGING P.C.
Entity Type:Organization
Organization Name:M.G.K.S.C.Z. MAGNETIC RESONANCE IMAGING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-518-2901
Mailing Address - Street 1:165 E 84TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2049
Mailing Address - Country:US
Mailing Address - Phone:212-535-9770
Mailing Address - Fax:212-427-5273
Practice Address - Street 1:165 E 84TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2049
Practice Address - Country:US
Practice Address - Phone:212-535-9770
Practice Address - Fax:212-427-5273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW13651OtherMEDICARE GROUP NUMBER