Provider Demographics
NPI:1407383888
Name:ICARE ULTRASOUND IMAGING, LLC
Entity Type:Organization
Organization Name:ICARE ULTRASOUND IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/SONOGRAPHER
Authorized Official - Prefix:
Authorized Official - First Name:HAMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZLE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, RDMS
Authorized Official - Phone:585-260-0837
Mailing Address - Street 1:7 CHAMBER VALLEY ESTS
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-9301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 CHAMBER VALLEY ESTS
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-9301
Practice Address - Country:US
Practice Address - Phone:585-260-0837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, MobileGroup - Single Specialty