Provider Demographics
NPI:1508225822
Name:BRMI @ 3RD AVENUE
Entity Type:Organization
Organization Name:BRMI @ 3RD AVENUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHROKH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABIRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-238-7000
Mailing Address - Street 1:6700 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5203
Mailing Address - Country:US
Mailing Address - Phone:718-238-7000
Mailing Address - Fax:
Practice Address - Street 1:7601 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3207
Practice Address - Country:US
Practice Address - Phone:718-238-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAY RIDGE MEDICAL IMAGING, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02390045Medicaid
NYW86421Medicare UPIN