Provider Demographics
NPI:1376034520
Name:SONOVIEW IMAGING LLC
Entity Type:Organization
Organization Name:SONOVIEW IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANATOLIY
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAFONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-459-7543
Mailing Address - Street 1:60 WESTERVELT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-1432
Mailing Address - Country:US
Mailing Address - Phone:917-459-7543
Mailing Address - Fax:718-818-8886
Practice Address - Street 1:5600 KENNEDY BLVD W STE 108
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1256
Practice Address - Country:US
Practice Address - Phone:201-624-1800
Practice Address - Fax:201-624-1465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty