Provider Demographics
NPI:1154860559
Name:PROMETHEUS IMAGING LLC
Entity Type:Organization
Organization Name:PROMETHEUS IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMIERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-335-5140
Mailing Address - Street 1:100 VINELAND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2320
Mailing Address - Country:US
Mailing Address - Phone:646-335-5140
Mailing Address - Fax:718-679-9285
Practice Address - Street 1:100 VINELAND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-2320
Practice Address - Country:US
Practice Address - Phone:646-335-5140
Practice Address - Fax:718-679-9285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile