Provider Demographics
NPI:1851422182
Name:LEVITTOWN IMAGING PC
Entity Type:Organization
Organization Name:LEVITTOWN IMAGING PC
Other - Org Name:HEMPSTEAD TPKE OPEN MRI AND IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:SOFIA
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-520-3800
Mailing Address - Street 1:2950 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1383
Mailing Address - Country:US
Mailing Address - Phone:516-520-3800
Mailing Address - Fax:516-520-3840
Practice Address - Street 1:2950 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1383
Practice Address - Country:US
Practice Address - Phone:516-520-3800
Practice Address - Fax:516-520-3840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176232174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW39071Medicare ID - Type UnspecifiedGROUP #