Provider Demographics
NPI:1558514620
Name:PREMIER IMAGING ASSOCIATES PLLC
Entity Type:Organization
Organization Name:PREMIER IMAGING ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-353-0400
Mailing Address - Street 1:85 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6950
Mailing Address - Country:US
Mailing Address - Phone:914-552-4001
Mailing Address - Fax:
Practice Address - Street 1:418 STANHOPE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4403
Practice Address - Country:US
Practice Address - Phone:845-353-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-03
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty