Provider Demographics
NPI:1285840280
Name:SUNRISE MEDICAL IMAGING, PC
Entity Type:Organization
Organization Name:SUNRISE MEDICAL IMAGING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARKAVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-872-7070
Mailing Address - Street 1:70 E SUNRISE HWY
Mailing Address - Street 2:SUITE 608
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1233
Mailing Address - Country:US
Mailing Address - Phone:516-872-7070
Mailing Address - Fax:516-872-7075
Practice Address - Street 1:70 E SUNRISE HWY
Practice Address - Street 2:SUITE 608
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1233
Practice Address - Country:US
Practice Address - Phone:516-872-7070
Practice Address - Fax:516-872-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY146612-12085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty