Provider Demographics
NPI:1669669198
Name:TOTAL GLOBAL MEDICAL PC
Entity Type:Organization
Organization Name:TOTAL GLOBAL MEDICAL PC
Other - Org Name:VISTA DIAGNOSTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:BEINART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-850-7200
Mailing Address - Street 1:11960 METROPOLITAN AVE
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2606
Mailing Address - Country:US
Mailing Address - Phone:718-850-7200
Mailing Address - Fax:718-850-7222
Practice Address - Street 1:11960 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2606
Practice Address - Country:US
Practice Address - Phone:718-850-7200
Practice Address - Fax:718-850-7222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1404402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY140440OtherNYS LICENSE