Provider Demographics
NPI:1083908768
Name:NEXRAY MEDICAL IMANGING,PC.
Entity Type:Organization
Organization Name:NEXRAY MEDICAL IMANGING,PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:718-459-9500
Mailing Address - Street 1:6555 WOODHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-5048
Mailing Address - Country:US
Mailing Address - Phone:718-459-9500
Mailing Address - Fax:718-459-9509
Practice Address - Street 1:6555 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-5048
Practice Address - Country:US
Practice Address - Phone:718-459-9500
Practice Address - Fax:718-459-9509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179573-2261QM1200X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherMAJOR MEDICAL