Provider Demographics
NPI:1174500227
Name:PHYSICIANS MRI, LLP
Entity Type:Organization
Organization Name:PHYSICIANS MRI, LLP
Other - Org Name:PHYSICIANS MRI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR/ RADIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEIBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-517-8006
Mailing Address - Street 1:PO BOX 18005
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-8805
Mailing Address - Country:US
Mailing Address - Phone:631-517-8000
Mailing Address - Fax:631-893-1923
Practice Address - Street 1:2625 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4031
Practice Address - Country:US
Practice Address - Phone:716-897-2207
Practice Address - Fax:716-824-7161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCJ9521OtherRR MEDICARE PIN
NYAA0062Medicare ID - Type Unspecified