Provider Demographics
NPI:1508308693
Name:IMAGING CONSULTANTS AND BILLING OF NY, LLC
Entity Type:Organization
Organization Name:IMAGING CONSULTANTS AND BILLING OF NY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:JANAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-399-5573
Mailing Address - Street 1:2152 RALPH AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1249 E 68TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5721
Practice Address - Country:US
Practice Address - Phone:347-702-9302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory