Provider Demographics
NPI:1639216054
Name:EMPIRE DIAGNOSTIC SOLUTIONS, INC.
Entity Type:Organization
Organization Name:EMPIRE DIAGNOSTIC SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KANTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-715-4665
Mailing Address - Street 1:1122 CONEY ISLAND AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2365
Mailing Address - Country:US
Mailing Address - Phone:347-715-4665
Mailing Address - Fax:347-715-4668
Practice Address - Street 1:1122 CONEY ISLAND AVE STE 220
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2365
Practice Address - Country:US
Practice Address - Phone:347-715-4665
Practice Address - Fax:347-715-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty