Provider Demographics
NPI:1760615298
Name:EXCEPTIONAL IMAGING LLC
Entity Type:Organization
Organization Name:EXCEPTIONAL IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIC TECHNOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PHINEAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LRT
Authorized Official - Phone:646-702-5087
Mailing Address - Street 1:41 POINT ST SUITE 1B
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701
Mailing Address - Country:US
Mailing Address - Phone:646-702-5087
Mailing Address - Fax:
Practice Address - Street 1:41 POINT ST SUITE 1B
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:646-702-5087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211067335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier