Provider Demographics
NPI:1841217528
Name:SONOGRAPHICS IMAGING INC
Entity Type:Organization
Organization Name:SONOGRAPHICS IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:TANZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-777-8300
Mailing Address - Street 1:141 HALSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-2607
Mailing Address - Country:US
Mailing Address - Phone:914-777-8300
Mailing Address - Fax:
Practice Address - Street 1:141 HALSTEAD AVE
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-2607
Practice Address - Country:US
Practice Address - Phone:914-777-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7408609Medicaid
NJ025620Medicare ID - Type Unspecified
NY97Z421Medicare ID - Type Unspecified
NY470000641Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJ470000915Medicare ID - Type UnspecifiedRAILROAD MEDICARE