Provider Demographics
NPI:1346865227
Name:TOTAL CARE RADIOLOGY PC
Entity Type:Organization
Organization Name:TOTAL CARE RADIOLOGY PC
Other - Org Name:ASTRA VEIN & ENDOVASCULAR MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLOTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-484-8215
Mailing Address - Street 1:4750 BEDFORD AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2623
Mailing Address - Country:US
Mailing Address - Phone:347-484-8215
Mailing Address - Fax:
Practice Address - Street 1:4209 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5121
Practice Address - Country:US
Practice Address - Phone:347-484-8215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical