Provider Demographics
NPI:1598269037
Name:WAVE IMAGING LLP
Entity Type:Organization
Organization Name:WAVE IMAGING LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ULTRASOUND TECHNOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARAISON
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RDMS, CPC-A
Authorized Official - Phone:347-302-2321
Mailing Address - Street 1:230 BEACH 102ND ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 BEACH 102ND ST STE 2B
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2871
Practice Address - Country:US
Practice Address - Phone:347-302-2321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1261782085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty