Provider Demographics
NPI:1790861730
Name:XXI CENTURY RADIOLOGY AND CARDIAC IMAGING PC
Entity Type:Organization
Organization Name:XXI CENTURY RADIOLOGY AND CARDIAC IMAGING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-236-1000
Mailing Address - Street 1:3046 OCEAN PARK WAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205
Mailing Address - Country:US
Mailing Address - Phone:718-236-1000
Mailing Address - Fax:
Practice Address - Street 1:3046 OCEAN PARK WAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205
Practice Address - Country:US
Practice Address - Phone:718-236-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty