Provider Demographics
NPI:1376842633
Name:INNERVISIONSONOGRAPHY INC.
Entity Type:Organization
Organization Name:INNERVISIONSONOGRAPHY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINIX
Authorized Official - Suffix:
Authorized Official - Credentials:RCS
Authorized Official - Phone:917-569-0027
Mailing Address - Street 1:4064 BRUNER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2229
Mailing Address - Country:US
Mailing Address - Phone:917-569-0027
Mailing Address - Fax:
Practice Address - Street 1:4064 BRUNER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2229
Practice Address - Country:US
Practice Address - Phone:917-569-0027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-24
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00072877246XS1301X
NY2471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty