Provider Demographics
NPI:1093721367
Name:21ST CENTURY RADIOLOGY AND IMAGING, PC
Entity Type:Organization
Organization Name:21ST CENTURY RADIOLOGY AND IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:YANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KARLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-333-0022
Mailing Address - Street 1:8686 BAY PKWY
Mailing Address - Street 2:SUITE M3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5119
Mailing Address - Country:US
Mailing Address - Phone:718-333-0022
Mailing Address - Fax:718-333-0054
Practice Address - Street 1:8686 BAY PKWY
Practice Address - Street 2:SUITE M3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5119
Practice Address - Country:US
Practice Address - Phone:718-333-0022
Practice Address - Fax:718-333-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1979882085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01663776Medicaid
G29877Medicare UPIN
NY01663776Medicaid