Provider Demographics
NPI:1346386943
Name:BROOKLYN NUCLEAR SPECT IMAGING, PC
Entity Type:Organization
Organization Name:BROOKLYN NUCLEAR SPECT IMAGING, PC
Other - Org Name:QUANTUM CARDIOVASCULAR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:VACCARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-992-6827
Mailing Address - Street 1:10401 CORONA AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-2923
Mailing Address - Country:US
Mailing Address - Phone:800-992-6827
Mailing Address - Fax:
Practice Address - Street 1:10401 CORONA AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-2923
Practice Address - Country:US
Practice Address - Phone:800-992-6827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Not Answered207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty