Provider Demographics
NPI:1659440238
Name:X RAY TECHNOLOGY OF BAY RIDGE, INC.
Entity Type:Organization
Organization Name:X RAY TECHNOLOGY OF BAY RIDGE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORP PRESIDENT LEAD XRAY TECHNITION
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIEI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-745-1150
Mailing Address - Street 1:588 BAY RIDGE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3310
Mailing Address - Country:US
Mailing Address - Phone:718-745-1150
Mailing Address - Fax:718-745-2573
Practice Address - Street 1:588 BAY RIDGE PARKWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3310
Practice Address - Country:US
Practice Address - Phone:718-745-1150
Practice Address - Fax:718-745-2573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W5F591Medicare ID - Type Unspecified