Provider Demographics
NPI:1427371756
Name:CUTTING EDGE PET/CF AND IMAGING PLLC
Entity Type:Organization
Organization Name:CUTTING EDGE PET/CF AND IMAGING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-963-7230
Mailing Address - Street 1:PO BOX 370670
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237
Mailing Address - Country:US
Mailing Address - Phone:718-963-7381
Mailing Address - Fax:718-963-7744
Practice Address - Street 1:93-95 WYCKOFF AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237
Practice Address - Country:US
Practice Address - Phone:718-963-7381
Practice Address - Fax:718-963-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty